Recently, the Montezuma County Republications hosted a presentation by the Colorado Health Institute. The CHC is a Denver-based nonpartisan nonprofit that uses evidence-based data and provides analysis of policy proposals and their impact. They shared information about the Colorado Health Access Survey, conducted February-July 2025. The presentation provided an overview of Southwest Colorado and H.R. 1 Impacts.
In Southwest Colorado, approximately 42% of the population falls within 0% to 400% of the Federal Poverty Level – more than 2,600 Montezuma County residents are below the 138% FPL. Approximately 60% to 64% of Montezuma County students qualify for free or reduced lunches The FPL is a measure of income that the Department of Health and Human Services updates each year. It represents the minimum annual income an individual or family needs to cover the basics: housing, utilities, food, clothing and transportation. The FPL is used to determine eligibility for a variety of programs: Medicaid, Children’s Health Insurance Program, tax credits to lower monthly health insurance premiums and the Supplemental Nutrition Assistance Program. To qualify for most public assistance programs, a person/family generally has to be at or below 138% FPL; 100% FPL is $15,960 annual income. As the number of household members increase, the annual income increases.
Ten percent of Southwest Coloradans don’t have health insurance; a rate 3.8% higher than the rest of the state, with 40.9% covered by Medicare or Medicaid. The Affordable Care Act provided subsidies for individual market coverage to help increase the number of Americans with health insurance. During COVID-19, ACA subsidies expanded to cover many above the 400% FPL. These subsidies ended Dec. 31, 2025, and many have seen their premiums skyrocket.
Cost of health care is a barrier for many. Other roadblocks include inability to get an appointment when needed, the provider not accepting one’s insurance or not taking new patients. Limited health care access often results in poorer outcomes for patients and higher costs for all when health care is delayed.
Colorado tax revenues are tied to federal tax policies and with the passage of H.R.1, Colorado revenues were negatively impacted. The bill also forbids states from using Medicaid to pay for non-abortion services at Planned Parenthood. These provisions triggered a Colorado special legislative session to determine how the revenue shortfall and Planned Parenthood restrictions would be addressed. Legislators allocated $4.3 million to cover Planned Parenthood primary care and family planning services, and they continue to wrestle with revenue shortfalls because of H.R.1.
Over the next several years, additional H.R.1 provisions will kick in. Medicaid eligibility will be rescinded for lawfully eligible immigrants, and additional requirements and restrictions will be attached to the ACA making it more difficult for low-income individuals to get health insurance. Eligibility checks for Medicaid and SNAP will increase from once to twice a year beginning in 2027, taxing the system and resulting in many losing their benefits simply because they missed a deadline. H.R.1 also mandates work requirements, even though states that instituted work requirements found that administrative costs were more than what they saved, and most who were not working were exempted.
H.R.1 established a $50 billion “Rural Health Transformation Program” to be distributed over 10 years to help offset Medicaid cuts; however, it will be a drop in the bucket compared to the estimated $137 billion to $155 billion Medicaid shortfall. Additionally, Montezuma County faces a $2.6 million cut as the result of the expiration of the Enhanced Premium Tax Credit and significant reductions in SNAP funding. These cuts will impact health care access and compensation, access to food and indirectly, businesses in the community that receive these funds in exchange for goods and services. We may pay dearly for the “Big Beautiful Bill”!
Karen Sheek of Cortez chairs the Montezuma County League of Women Voters and is a former Cortez mayor and city councilor. Contact lwvmzc@gmail.com or find the League on Facebook at https://tinyurl.com/bdcjr8pn.
