According to the Colorado Fiscal Institute, 92% of people enrolled in Medicaid are already working, in school, or caregiving even without the proposed new work requirements. House Bill One’s work requirements will kick in on January 1st of 2027 unless a state chooses to opt in sooner, like Georgia has. The Center for Budget and Policy Priorities, a nonpartisan research group, says it’s not going well.
The paperwork that comes with work checks is resulting in administrative backlogs and higher spending on systems updating that could be going into health services.
During the first Trump administration in Arkansas, 18,000 people lost coverage when the state implemented similar requirements. Many low-income individuals on Medicaid are subject to things like random shift changes, or they could fall ill or become disabled. If this were the case they could theoretically reapply to Medicaid, but the backlog of administrative work means longer wait times, or more time spent without medical care.
A federal court eventually ruled Arkansas’s work requirements as unlawful.
1 in 5 Coloradans are enrolled in Medicaid, but on the Western Slope in CD3, it's 1 in 4. The Bell Policy Center’s Chris deGruy Kennedy says that what happened in Arkansas could be even worse for rural Colorado.
“What we're anticipating is that we're going to need 3,700 new county level employees across the state just to administer this new healthcare bureaucracy. These are resources that a lot of small counties frankly cannot afford, so we may see longer wait times to get paperwork processed, slower responses through appeals or confusing issues that may lead to a much higher percentage of Coloradans losing their Medicaid even while they are working.”
There are some exemptions to the work requirement rule, including pregnant people, foster youth, the medically frail, and so on. But, these are people who likely are already not a part of the over 90% of Medicaid enrollees who work full time, part time, or otherwise qualify for exemption. This is the second installment in a series examining rural healthcare through the lens of federal changes.