22-05-2025
Colorado department: Medicaid work requirements could cost state millions
DENVER (KDVR) — Congressional lawmakers have been working around the clock on what the president is calling 'One Big Beautiful Bill': a budget plan to fund his agenda.
Medicaid continues to be a focal point for people watching the bill's movement. One provision of the bill could determine who is eligible to receive benefits.
Experts said about 60% of Coloradans on Medicaid already meet these requirements. The tough part could be proving it.
'Medicaid has kind of run on its own, the requirements haven't changed significantly,' said Jessica Greenfield, Associate Professor at the University of Denver Graduate School of Social Work.
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The budget bill making its way through Congress could change that. The bill that would reduce federal spending on Medicaid seeks to change how people prove their eligibility, asking them to show their community engagement by spending 80 hours a month at a job, work training, school or volunteering part-time.
'It is a practice that is used in a couple of programs. For instance, the Temporary Assistance for Needy Families program implemented work requirements a long time ago. It's being used in two states with the medicaid program as well. So there is some history and there is a great deal of research on what the impacts of work requirements have been,' Greenfield said.
An April report from the Colorado Department of Health Care Policy and Finance shows that when Arkansas implemented its work requirement, it ran its state $26 million in administrative costs. If this new policy passes, HCPF says it would cost Colorado $57 million due to the state's county administrative model. Even with that cost analysis, Governor Jared Polis said the work requirements are the least egregious part of the plan.
'Frankly, we would be fortunate if we emerge from this with requirements that had sufficient flexibility for states to successfully implement them. So you know, they are talking about much harsher actual cuts to Medicaid dollars, cuts that would either force a reduction in benefits and force, if not a full rollback of the medicaid expansion that Colorado has,' Polis said at a press conference with other Democratic governors.
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Experts believe the policy could place a heavy burden on recipients to prove their status and on counties enforcing the policy. They worry it could be a slippery slope, jeopardizing healthcare for some 1.2 million Coloradans on Medicaid.
'If you're working, taking time out of that workday to get the paperwork submitted can be really difficult, especially if you're in an hourly job where every hour is monitored. It also is putting a huge burden on the counties that actually administer these programs. So it would end up being a major cost increase for states and counties,' said Greenfield. 'Instead of supporting somebody who has a chronic disease to manage, we will instead be causing them to forgo medications, forgo doctors' visits, turning to ERs instead of seeing primary care. Those ripple effects will be very costly for our system, but also costly in terms of human lives.'
HCPF estimates 377,000 Coloradans could lose coverage under those medicaid expansion cuts. Originally, the bill called for these provisions to be put in place by 2029, but some members of Congress said that was not soon enough. Leaders now anticipate that the requirements could be in effect by 2027 if the bill passes.
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