New Federal Rules Mean Medicaid Changes for Thousands of Noncitizens Across Colorado
Thousands of immigrants in Colorado are expected to lose their full Medicaid coverage beginning Thursday, Oct. 1, as new federal eligibility requirements take effect.
The change stems from the federal reconciliation law passed in 2025, which changed the categories of noncitizens who can receive federally funded Medicaid coverage.
Colorado legislative staff estimate that approximately 7,000 people in the state will lose their full Medicaid coverage as a result of the changes. The affected groups include some refugees, asylees, people with Temporary Protected Status and individuals with humanitarian parole.
The changes do not apply to every immigrant enrolled in Health First Colorado, Colorado's Medicaid program. Certain groups, including some children and pregnant women, may continue to qualify for coverage through state programs.
Where is the Medicaid Money Coming From?
Medicaid is not funded solely by Colorado taxpayers.
Health First Colorado is jointly funded by the federal government and the state. Federal Medicaid funding is generally provided through a matching system, meaning the federal government contributes funding based on the amount states spend on eligible Medicaid services.
According to the Colorado Department of Health Care Policy and Financing, approximately 60% of its overall budget comes from federal matching funds. The remaining funding comes from state and other sources, including Colorado's General Fund.
That means taxpayer dollars support Medicaid at both the federal and state levels.
The new federal law changes which groups are eligible for federal Medicaid funding. As a result, Colorado can no longer receive the same federal matching funds for certain categories of immigrants.
The Centers for Medicare and Medicaid Services said the changes are intended to align federal Medicaid and Children's Health Insurance Program funding with the eligibility requirements established under federal law.
Nationally, the federal government estimates the changes will reduce federal Medicaid and CHIP spending by billions of dollars over the next several years.
What happens to those losing coverage?
Losing full Medicaid coverage does not necessarily mean an individual will have no access to health care.
Health First Colorado lists several alternatives, including emergency Medicaid services, reproductive health services, community health centers, hospital financial assistance and private insurance through Connect for Health Colorado.
Emergency Medicaid services will remain available to people who otherwise meet Medicaid eligibility requirements when they need treatment for an emergency medical condition.
Some children and pregnant women may also remain eligible for Colorado's Cover All Coloradans program, regardless of immigration status.
Health First Colorado says people affected by the changes should receive notices regarding their coverage and should review other health insurance options before their Medicaid coverage ends.
The changes represent a shift in federal Medicaid eligibility and will affect thousands of people across Colorado beginning Oct. 1.
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