CO SB228

Creates the Healthcare Affordability and Sustainability Medicaid Buy-In Cash Fund within the Colorado Healthcare Affordability and Sustainability Enterprise to hold premiums paid by low-income individuals with disabilities for Medicaid buy-in programs

Establishes a five-member Medicaid Buy-In Enterprise Support Board appointed by the Governor, including representatives of persons with disabilities, disability rights organizations, and state department employees, serving four-year terms

Transfers the balance of the existing Medicaid Buy-In Cash Fund to the new enterprise fund on June 30, 2025, and repeals the original fund effective July 1, 2025

Classifies Medicaid buy-in premiums as fees rather than taxes to maintain enterprise status under TABOR (Article X, Section 20 of the Colorado Constitution), ensuring revenues do not count against state fiscal spending limits

Adjusts appropriations by shifting $6,660,761 (FY 2025-26) and $1,110,126 (FY 2024-25) from the old Medicaid Buy-In Cash Fund to the new enterprise fund for medical and long-term care services