Why ‘One Big Beautiful Bill’ Could Threaten Health Care Access for Thousands in Colorado’s High Country

I’m reaching out to Sens. Michael Bennet and John Hickenlooper and Reps. Jeff Hurd and Joe Neguse on behalf of Mountain Family Health Centers and our 20,000 patients in Colorado.

At Mountain Family, we run eight clinics across Garfield, Eagle, and Pitkin counties. We focus on whole-person care, offering medical, dental, behavioral, and pharmacy services at all locations. Our team includes enrollment specialists and care coordinators who help our patients access health insurance and support with housing or food insecurity.

I want to express my deep concern about HR 1, the “One Big Beautiful Bill.” This legislation could seriously hurt our patients, especially those who depend on Medicaid for essential care.

The regions we serve have higher uninsured rates than much of Colorado. Many patients work at jobs with salaries above the Medicaid threshold of $44,367 for a family of four, making them ineligible while still unable to afford healthcare. The provisions in H.R. 1 could push health coverage further out of reach, worsening access for those in need.

One troubling aspect is the work requirement included in the bill. While it may seem logical, 92% of Medicaid enrollees are already employed, disabled, students, or caregivers. Implementing these requirements would demand significant administrative resources—Colorado estimates it would cost $57 million and require 3,700 new case managers to manage the system.

These measures would add more hurdles for Medicaid recipients, making it harder for them to maintain their coverage. Experts worry that if this bill passes, over 300,000 Coloradans could lose their health insurance in the next decade due to confusion and increased costs, rather than ineligibility.

A recent report from the Brookings Institute highlights that this bill could have a disproportionate impact on those working in the service industry, which is a vital part of our local economy. When these people lose Medicaid coverage, Mountain Family will still provide care, but the rising number of uninsured patients poses a threat to our sustainability. During Colorado’s Medicaid unwind, we saw 2,000 patients lose coverage, leading to a $1.5 million revenue loss that resulted in layoffs and clinic closures.

Additionally, changes to the Affordable Care Act (ACA) exchanges could affect Colorado’s marketplace, with potential coverage losses for 112,000 residents. Removing year-round enrollment options for those earning up to 150% of the federal poverty level would limit access and strain enrollment resources.

Recent changes could increase average premiums by 39%, pushing 23,000 Coloradans out of insurance. New verification processes may cause delays in financial assistance, increasing barriers for many who already struggle to access care.

I appreciate your commitment to Colorado’s communities and urge you to reject H.R. 1. It is crucial to protect healthcare access for our patients and all Coloradans.

Dustin Moyer,
CEO, Mountain Family Health Centers
Glenwood Springs, CO



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