For Colorado, the Medicaid cuts Rep. Gabe Evans (R-Colorado) voted for aren’t a distant, Washington budget fight. They could mean hundreds of thousands of people facing new hurdles to keep their coverage, billions in lost federal funding, job cuts and another hit for rural hospitals already struggling to stay open.
Evans, who represents the 8th Congressional District north of Denver, voted for the cuts in the “One Big Beautiful Bill Act” but has emphasized the importance of maintaining access to health care in his public-facing materials.
On his House issues page, Evans says, “I truly appreciate how important it is for all Americans and Coloradans to have access to quality healthcare and insurance coverage, including for pre-existing conditions.”
Evans has defended the changes by arguing that Medicaid needs to crack down on fraud, waste and abuse while protecting people who are legitimately eligible. In a 2025 interview, he said Medicaid expansion recipients “deserve health care,” but argued that policymakers should prioritize traditionally eligible populations, including children, pregnant women and people with disabilities.
In touching on these cuts during an Oct. 7 debate, Evans stood by his long-held assertion that they will put a stop to rampant abuses and fraud within the system.
His Democratic challenger, former state Rep. Manny Rutinel of Commerce City, called for a reversing the laws Medicaid cuts and suggested a provision of citizenship for undocumented but taxpaying immigrants.
During a Colorado Public Radio interview, Rutinel said he has relied on federal safety-net programs himself, and that cuts will hurt Coloradans.
“Those are the same programs that Donald Trump and Gabe Evans are destroying right now to give tax breaks to their billionaire donors. And they’re making the price of healthcare dramatically rise for working families across this district,” he said.
What happens next for Colorado health care providers and Medicaid recipients
Local officials are already preparing. Adams County, which reported 163,748 residents enrolled in medical assistance programs as of August, has held community roundtables with local agencies, cities and school districts to help them understand the new requirements and prepare for their effects.
County officials said they do not yet have reliable estimates of how many Adams County residents could be affected. But some changes are already taking effect: Certain lawfully present noncitizens became ineligible for medical assistance on Oct. 1, according to the county. Statewide, about 5,900 legal immigrants, including refugees and asylum seekers, lost Medicaid coverage that day, Sentinel Colorado reported.
“The most immediate impact is related to disenrollments,” said a spokesperson for the county’s Human Services Department in an email to Courier Colorado. “Additional changes, such as work requirements and additional recertifications, have not yet been implemented but are anticipated to both increase administrative burden and result in ineligibility for some individuals.”
As of August, nearly 1.25 million Coloradans were enrolled in Health First Colorado, the state’s Medicaid program, according to the Colorado Department of Health Care Policy & Financing. Another roughly 69,000 were enrolled in Child Health Plan Plus, the state’s separate health coverage program for eligible children and pregnant persons.
The department estimates that 375,000 people statewide will be subject to work requirements and six-month renewals before exemptions are applied, the Adams County Human Services Department noted. Of those, the state expects about 175,000 will need to take action to keep their coverage, Denver7 reported.
Long-term impact on Colorado health systems
The law will reduce funding through Colorado’s hospital provider fee by $10.4 billion over five years, according to the Colorado Hospital Association,
The association warns that hospitals, now facing lower reimbursements and more uncompensated care, may be forced to reduce services and jobs. Nearly 70% of Colorado hospitals are already financially vulnerable, according to the association, underscoring the financial strain facing providers even before the full effects of the federal changes take hold.
The work requirements and six-month renewals start Jan. 1, 2027, less than two months after 8th District voters choose between Evans and Rutinel on Nov. 3.
Evans’ office did not respond to requests for comment by the time of publication.
