As of Oct. 1, 6,000 to 7,000 Coloradans have lost access to Health First Colorado, the state’s Medicaid program for people with low incomes. They include refugees, people granted asylum and other immigrants who are in the country legally.
They’re the first people in Colorado to lose coverage under a law Rep. Gabe Evans voted for last year. And it’s only the beginning.
County clerks can start mailing ballots for Evans’ race Oct. 2. Here’s what he voted for and what it means for people in his district.
What did Evans vote for?
In July 2025, Evans voted yes on H.R.1, commonly referred to as the “One Big Beautiful Bill,” Republicans’ huge tax and spending law. It passed the House by just four votes, 218-214.
Among many other things, the law makes it harder to qualify for Medicaid and limits how states can pay for it. Colorado’s Medicaid agency estimates the state could lose up to $2.5 billion a year in federal health care money by 2032.
Evans says the law “strengthens Medicaid for the most vulnerable” and targets waste and fraud. On Sept. 28, he hosted Dr. Mehmet Oz, who runs the federal Medicare and Medicaid agency, in Greeley and introduced a bill aimed at Medicaid fraud. He also points to new money for rural health care, about $200 million for Colorado in the program’s first year.
About one in four people in Evans’ district are on Medicaid, according to the state’s Medicaid agency..
Who will lose coverage, and when?
The biggest changes start Jan. 1, two months after Election Day.
That’s when many adults on Medicaid will have to prove they work, go to school or volunteer at least 80 hours a month to keep their coverage. Parents of children 13 and younger and people with disabilities are among those who won’t have to. Many will also have to renew their coverage every six months instead of once a year. The state has sent letters to about 377,000 Coloradans who could be affected.
About 17,000 people in Evans’ district could lose Medicaid because of the work rules by 2034, according to an estimate from the Center on Budget and Policy Priorities, a left-leaning think tank.
Local hospitals could feel it too. Platte Valley Medical Center in Brighton and North Colorado Medical Center in Greeley are among nine Colorado hospitals that Public Citizen, a left-leaning consumer advocacy group, rated at high risk from the cuts.
READ MORE: The real math behind CO-8’s Medicaid ad war
Why is health insurance getting more expensive?
Part of that traces back to a different vote.
For years, extra federal tax credits under the Affordable Care Act lowered the cost of health insurance for people who buy their own plans through Connect for Health Colorado, the state’s insurance marketplace. That help ran out at the end of 2025.
In January, the House voted to bring it back for three years. Seventeen Republicans, including Colorado Rep. Jeff Hurd, voted yes. Evans voted no. He said in a statement he was open to a version that added more limits and slowly phased the help out, “but this is not it.” The bill stalled in the Senate.
Because the help ran out, Connect for Health Colorado says 78,000 Coloradans lost some or all of their help paying for insurance this year when the credits expired. And prices are going up again next year, by about 10% in the Denver and Greeley areas, according to the Colorado Division of Insurance.
What happens next?
Sign-ups for 2027 marketplace plans start Nov. 1, two days before the election. You can compare plans at connectforhealthco.com. If you’re on Medicaid, you can check whether you’re affected and when you need to renew at healthfirstcolorado.gov.
Ballots must be received by 7 p.m. Nov. 3, and postmarks don’t count. The state suggests using a drop box or voting center after Oct. 26.
