If the Republicans’ bill to extend 2017 tax cuts, known as H.R. 1, passes through Congress, more than 21,000 undocumented individuals in Colorado could lose their Medicaid coverage. This bill includes a provision that penalizes states like Colorado for using their own funds to cover undocumented individuals. While Colorado currently covers undocumented children who sign up for Medicaid, coverage for adults is limited to pregnant and postpartum women.
The proposed bill would decrease the federal government’s share of costs for the expansion population, affecting adult citizens who earn up to 138% of the poverty line and do not qualify for Medicaid due to pregnancy or disability. This reduction would force states to find additional funds to cover this population or to cease insuring undocumented individuals.
Colorado stands to lose approximately $300 million in federal funding annually if the federal government reduces its share, according to Governor Jared Polis. With a projected $700 million budget deficit next year, the state faces challenges in maintaining coverage for undocumented individuals.
The Congressional Budget Office estimates that around 11.8 million people could lose coverage, leading to a $1.1 trillion decrease in federal spending on health insurance programs, primarily impacting Medicaid. However, the bill would also increase the deficit by approximately $3.3 trillion due to tax cuts and increased spending on other priorities.
The House and Senate have passed different versions of the bill, with deeper cuts proposed in the Senate. President Donald Trump has expressed his desire to have the bill align with his policy agenda by Friday.
The Colorado Department of Health Care Policy and Financing reported that as of June 22, 21,261 undocumented individuals were covered by Medicaid. While the majority were children, the rest qualified due to being pregnant or in the postpartum period.
In addition to impacting Medicaid coverage, the bill in Congress would also restrict tax credits for immigrants with legal status seeking health insurance on the federal marketplace. Only specific categories of immigrants, such as permanent residents and individuals from certain countries, would qualify for tax credits.
Furthermore, the Trump administration announced changes that would prevent undocumented individuals who arrived in the country as children, known as “Dreamers,” from purchasing coverage on the marketplace.
Overall, the bill’s implications extend beyond Medicaid coverage, affecting the availability of insurance for many individuals in Colorado and potentially leading to a significant reduction in Medicaid revenue for healthcare providers like Tepeyac Community Health Center in Denver.
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