Ongoing Changes to Medicaid: What You Need to Know

The passage of the federal HR 1 bill in 2025, along with other budget challenges in Colorado, have brought many changes to the state’s Medicaid program (Health First Colorado). Some changes have already happened, while others will be implemented soon. 

For Medicaid members, staying informed of these changes is one of the best ways to make sure you remain eligible for the coverage you need. Below, we summarize the most current information on new Medicaid changes, who will be affected, and what you can do right now to prepare.

Important: All information below is based on current guidance from the Department of Health Care Policy & Financing (HCPF) as of July 27, 2026. This guidance may be subject to change. Please check HCPF’s website for the most up-to-date guidance on Health First Colorado changes.

Medicaid Work Requirements

Beginning January 1st, 2027, many Medicaid members will need to meet work requirements to keep their Medicaid coverage. Work requirements are sometimes called community engagement requirements.

To meet work requirements, some Medicaid members will have to show they worked, participated in a work program, volunteered, or went to school (or a combination of these) for at least 80 hours in one month. They may also show that they earned at least $580 from paid work in one month.

New applicants will have to show they met work requirements in the calendar month before their application. Current members who are initiating a renewal will have to show they met requirements in at least one calendar month since their last renewal deadline.

Work requirements will apply to members in the “expansion population”—in other words, some adults ages 19 through 64 with limited income. Many people with disabilities will not have to comply with work requirements. You should not have to meet work requirements if you:

  • Are enrolled in a Long-Term Services and Supports (LTSS) program
  • Are enrolled in Medicaid buy-in programs (Working Adults or Children’s)
  • Are receiving Supplemental Security Income (SSI) and/or Social Security Administration (SSA) income, such as Social Security Disability Insurance (SSDI)
  • Are a caretaker family member or guardian responsible for caring for a person of any age with a disability

Others may also be exempt from work requirements. Click here to view the full list of who is expected to be exempt.

People with disabilities who do not meet any of these criteria may also qualify for an exemption if they meet the definition of medically frail. Click here to learn more.

In the meantime, be on the lookout for communication from Health First Colorado. They will contact you if they need additional information to show that you have met work requirements or qualify for an exemption. HCPF has announced that members who must comply with work requirements will begin receiving letters in August.

  • Make sure your contact information is correct and up-to-date in Colorado PEAK.
  • Check your mail and respond promptly to any requests from Health First Colorado for more information.

Learn more: You can find more information about Health First Colorado Work Requirements here. In addition, HCPF held two webinars in July 2026 covering Work Requirements and Medical Frailty. When available, recordings of both webinars will be posted here.

Other Changes to Medicaid

As you are likely aware, many other changes have also been made to Health First Colorado. These have included various rate reductions, service caps, and other changes impacting Long-Term Services and Supports (LTSS). All changes are listed here.

Do you have questions about how these changes affect you? Your case manager should have met with you already, or should be planning to meet with you, about any changes that apply to you. These discussions should occur before the change begins to impact your services.

Reach out to your case manager if you have any questions or would like to learn about any exceptions processes for changes that affect you.