Getting health care is about to get a lot harder for thousands of legal immigrants in Colorado, who saw their Medicaid coverage revoked Thursday.
The changes come as Coloradans who rely on food assistance are waiting to see if Congress passes the Farm Bill within the next couple of months, or watch a government shutdown disrupt funding.
A group of refugees and asylees, people officially granted asylum after arriving in or seeking entry into the country, had their federal Medicaid eligibility withdrawn as of Oct. 1.
“I’m hearing a lot of fear. I feel like there has been a lot of confusion. There’s been no comprehensive communication to the communities that are being impacted by these changes,” said Nicole Cervera Loy, senior policy manager at COLOR, which is the Colorado Organization for Latina Opportunity and Reproductive Rights.
The group has been trying to spread the word that the federal government is cutting off many immigrants from the state’s Medicaid program, known as Health First Colorado.
Members contacted this summer
The agency that runs that program, the Department of Healthcare Policy and Financing, said it began contacting potentially impacted members in May and June to let them know they may lose coverage due to the federal changes, via texts and emails.
“I’m hoping that they are not surprised. We’ve been very intentional about communicating that these changes were coming,” said Marivel Klueckman, the Eligibility Division Director with Colorado’s Department of Health Care Policy & Financing.
The coverage change will have an impact, both on families that rely on the coverage and hospitals, clinics and health centers that provide them care.
“I think there’ll be some uncompensated care,” she said, noting some people losing their Medicaid benefits may absorb some additional financial expenses trying to pay out of pocket. “I’m concerned that they’ll just decide to not get any care because they just maybe can’t.”
Another key federal program, the Supplemental Nutrition Assistance Program, or SNAP, is in the middle of a major change to its funding model — as federal support is reduced, states like Colorado will have to carry a bigger chunk of the bill.
Still, people should continue to seek help, said state officials.
“My big point is I just don’t want people to stop applying or stop engaging with the program,” said Abby McClelland, Director of Food and Energy Assistance for the Colorado Department of Human Services.
The first hurdle ahead is the passage by lawmakers in Congress of the Farm Bill, which expired Wednesday.
“The Colorado SNAP program is stable and reliable right now and fully funded with benefits through Dec. 11tas part of the continuing resolution,” said McClelland. “We don’t know if we’ll see a Farm Bill pass or there could be a Farm Bill extension as there has been in previous years. There’s a lot of mechanisms by which benefits’ funding could be extended, and we’re just hopeful that we will avoid a shutdown like happened last year.”
Folks on the food assistance frontlines say these are anxious days.
The head of the Food Bank of the Rockies, for example, said it provides enough food every day for 200,000 meals. SNAP provides nine times that volume.
“If lawmakers don’t do anything by Dec. 11, there could be a disruption in SNAP benefits. And that’s something sometimes people think, well, food banks and food pantries can fill that gap that we can fill in the need,” said Erin Pulling, CEO of Food Bank of the Rockies. “We are seeing more of a need than we can meet.”
The federal changes come as Colorado has faced its own budget crisis, which has spurred deep cuts to Medicaid, with more expected down the road.
Who among Colorado’s immigrant population do the Medicaid changes impact?
Refugees, asylum seekers, people granted humanitarian parole, people granted withholding of removal, survivors of trafficking or domestic violence, and others who previously qualified for full Medicaid coverage are the ones affected, according to the state’s Medicaid agency.
Changes do not affect U.S. citizens or nationals, lawful permanent residents who meet applicable requirements, certain Cuban or Haitian entrants, children younger than 19, and people who are pregnant or were pregnant within the past 12 months may continue to qualify, according to a state Medicaid spokesperson.
Around 5,900 people are losing that coverage, according to state estimates. All are legal immigrants.
These changes are coming due HR1, the One Big Beautiful Bill Act, which Republicans and President Donald Trump passed last year. That law made a lot of changes to the nation’s safety net programs. One of those is that people with certain types of legal immigration status can no longer get on Medicaid.
COLOR’s Nicole Cervera Loy said this change, along with all the other ways the federal government is targeting immigrants right now, is having a chilling effect, even for people who weren’t on the program.
“They are seeing these bills pass over and over again, and the discussion always ends up in who is deserving of care. So we are already seeing many members of our community feel like they are not. They are no longer deserving of care,” Loy said.
“So they are already not going to the doctor,” she said. “They are already not wanting to sign up for the coverage programs that we have on the state side.
Many immigrants and their providers have told CPR there’s an increasing fear about getting medical care right now, which can have real consequences for people’s health.
What will this mean for Coloradans losing Medicaid coverage?
It probably means a lot less preventative care, for one thing. When people stop getting preventative care, particularly folks who are low-income, the consequences can be much bigger than someone’s individual health.
“They may not get the care that they need,” said Klueckman. “It may end up escalating to a point of emergency because they’re not getting that proactive care ahead of time. “
If more people are waiting until they have to go to the emergency room, and then showing up without any way to pay, those costs eventually get passed along to the whole health care system.
What coverage options are there for members who lost, or may lose Medicaid coverage?
People who receive a letter saying they will no longer qualify for benefits from the state’s Medicaid program, Health First Colorado, should also explore other health coverage options depending on their situation, including:
- Emergency Medicaid Services and Reproductive Health Care Services
- Hospital Discounted Care
- Community Health Centers
- OmniSalud
- Cover All Coloradans
- Connect for Health Colorado
What changes are coming to SNAP, the federal food assistance program?
Although eligibility changes for SNAP actually started rolling out earlier this summer.
We’ve already seen around 50,000 Coloradans lose their SNAP benefits because of changes to work and immigration status requirements.
The changes this week are on the administrative side. Now Colorado is responsible for 75% of what it costs to run the SNAP program here.
The state could end up on the hook for up to 15% of the actual cost of the benefits because of Colorado’s error rate.
That would be a big expense, coming at a time when the state already doesn’t have enough money for its current expenses.
Could Colorado cover federal cuts to SNAP?
State officials say they’re working to bring that error rate down, but there’s also concerns about funding for the SNAP program as a whole.
As of right now, Congress has only funded SNAP through December 11th, and we could see another interruption to benefits like Colorado saw last year. That has a compounding effects on people’s lives, according to advocates.
“What we’re seeing across Colorado and Wyoming is really unfathomable. There’s a lot of fear. There’s a lot of loss of benefits,” said Erin Pulling, CEO of the Food Bank of the Rockies. “A lot of people are afraid to even apply for or receive SNAP benefits, and we are seeing neighbors in desperate situations, people having to make choices that none of us should have to make, like do they fill a prescription or pay their rent or buy groceries?
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