Federal Medicaid Changes Affecting Colorado’s Immigrant Communities

September 17th, 2026 – Starting October 1, 2026, some immigrants who currently have Health First Colorado (Medicaid), will lose that coverage because of a federal law called H.R. 1. This page explains who is affected, who is not, what to do before the date, and where to find official help. It is a plain-language summary of the information Colorado’s Medicaid agency has published, with links to the original state sources so you can read them yourself.

Another impact of H.R. 1 is that most non-permanent legal residents will lose federal premium tax credits for health insurance coverage through Connect for Health Colorado, starting January 1st, 2027. Exceptions include: lawful permanent residents (green card holders), Cuban and Haitian entrants and COFA migrants (citizens of Palau, Micronesia, and the Marshall Islands. They can still have health insurance coverage, but will have to pay the full non-subsidized premium. 

What is changing and why

The federal government, through a bill known as H.R. 1, made changes to state Medicaid programs across the country. Colorado’s Medicaid program is called Health First Colorado. The Colorado Department of Health Care Policy and Financing, which runs the program, is putting those federal changes into effect on a set schedule.

Three things are happening as a result of the law:

• Certain members are being disenrolled, including many refugees and asylees.
• New restrictions are being added for some people who still qualify, including work requirements and more frequent renewals starting in 2027.
• Colorado’s federal Medicaid funding is affected.

This page covers the first of those three, the immigrant eligibility changes that take effect October 1, 2026. The state notes that timing and details can shift as federal guidance is finalized, so check the official pages linked below for the current rules.

Who keeps Health First Colorado coverage

These groups continue to qualify for Health First Colorado after October 1, 2026, as long as they meet all other eligibility requirements such as income:

Who is losing coverage on October 1

Unless an exemption applies, people in these groups lose Health First Colorado coverage on October 1, 2026:

• Refugees and asylees
• People granted humanitarian parole
• People granted withholding of removal
• Noncitizen survivors of domestic violence with a pending or approved application under the Violence Against Women Act who were not born in the U.S.
• Noncitizen survivors of trafficking with a pending or approved application for a victim of trafficking visa, known as a T-visa, who were not born in the U.S.
• Members of a federally recognized Indian tribe, or American Indians born in Canada, who do not yet have U.S. citizenship
• Refugees with a “conditional entrant” status granted before 1980

Special situations, including green card holders

Green card holders and the five-year rule

If you are a lawful permanent resident, you generally must have held a qualifying immigration status for five years, or be exempt from that requirement. One detail matters here: the five-year count starts when you received any type of qualifying immigration status, not necessarily when you received lawful permanent resident status.

These groups are exempt from the five-year requirement:

• Refugees who adjusted to lawful permanent resident status
• Asylees who adjusted to lawful permanent resident status
• Special Immigrant Visa (SIV) holders who adjusted to lawful permanent resident status
• Certain Cuban or Haitian entrants
• COFA migrants

Refugees with a green card

Refugees who have a green card and have adjusted to lawful permanent resident status remain exempt from the five-year bar. Refugees who are still awaiting lawful permanent resident status, and who do not have another qualifying immigration status, will lose coverage.

Pregnant people and children

Lawfully present pregnant immigrants and lawfully present children age 18 or younger may continue to qualify for full Health First Colorado coverage if all other eligibility requirements are met. If you are pregnant, make sure that information is current with your county and in your PEAK account.

If you receive SSI or SSDI

These changes still apply. If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) and your immigration status is one that no longer qualifies, you will no longer be eligible for Health First Colorado. Members disqualified based on immigration status lose coverage on October 1, 2026. Members who received care through Medicare and are disqualified based on immigration status lose that coverage January 1, 2027.

How you will know if you are affected

If you are affected, you should have received an official notice in September 2026. Notices, emails, and texts also went out in May 2026 to affected immigrant members.

You can view your notices by signing in to your account on Colorado PEAK, the state’s online benefits portal. If you have not looked at your PEAK account recently, this is the first place to check.

What to do before October 1

1. Verify your immigration category and update your documents. The specific category on file determines your eligibility, and an out-of-date record can produce the wrong result.
2. Update your contact information in PEAK so notices actually reach you. This includes your mailing address, phone number, and email.
3. If you are pregnant, confirm that your county and your PEAK account have that information.
4. Schedule appointments and fill prescriptions now. Many prescriptions can be filled for more than a one-month supply. Your Regional Accountable Entity (RAE) can help you get in to see a provider quickly.
5. Read the official FAQs from the Colorado Department of Health Care Policy and Financing and Health First Colorado, linked in the resources section below.
6. Check whether you are subject to the new work requirements if you still qualify for coverage. The state has a work requirements screener for this.

Coverage and care options if you lose Medicaid

Health insurance you can apply for now

• Connect for Health Colorado, the state’s health insurance marketplace, is where you can find out whether you qualify for a private health insurance plan and for financial help paying for it. Losing Health First Colorado coverage is a qualifying life event that opens a special enrollment period, so you do not have to wait for open enrollment.
• Your employer, if you are working. Losing other coverage generally allows you to join an employer plan outside of its normal enrollment window. Ask your human resources contact about the deadline.
• OmniSalud, available through Connect for Health Colorado, is a program for Coloradans who are not eligible for other coverage because of immigration status.

Limited Medicaid services that may still be available

• Emergency Medicaid covers emergency medical conditions for people who meet income and residency rules but do not qualify for full coverage because of immigration status.
• Reproductive Health Care Services covers family planning and related services for people who qualify.
• The Old Age Pension Health and Medical Care Program may be an option for older adults who need medical services and no longer qualify for Health First Colorado.

Care you can get without insurance

• Federally Qualified Health Centers and other community health centers provide primary care on a sliding fee scale based on income.
• Community Behavioral Health Centers provide mental health and substance use services.
• Other free or low-cost clinics operate in communities across Colorado.
• Prescription drug discount programs can reduce the cost of medications while you are between coverage.

If you think the decision is wrong

If you received a notice and believe you should not have, you can follow the “appeal an eligibility decision” process. Two timing rules matter:

• You must first ask for an informal meeting with your eligibility site within 60 days of the date on your notice.
• To continue receiving benefits while the appeal is decided, members need to file the appeal by September 30, 2026.

Common reasons people file an appeal include an immigration status that is not addressed in available guidance, conflicting immigration verification information, questions about how the five-year waiting period or an exemption was applied, an unexpected eligibility result in the state’s system, a possible system defect, or a policy question that cannot be resolved through existing resources.

Timeline of changes

The state describes this as a working timeline. Timing is subject to change as federal guidance is finalized.

• May 2026Notices, emails, and texts sent to affected immigrant members.
• September 2026Notices, emails, and texts sent to affected members.
• October 1, 2026Coverage changes take effect for some immigrants.
• October 2026Notices, emails, and texts sent for January renewals.
• January 1, 2027Six-month renewals begin, work requirements begin, and retroactive coverage changes take effect. Members who received care through Medicare and are disqualified based on immigration status lose that coverage.
• Through 2027Direct outreach to members continues based on each member’s renewal date.

Official resources and links

Every link below goes to a Colorado state agency or an official program site.

Source: The information here summarizes “Federal Medicaid Changes Impacting Colorado’s Immigrant Communities,” a public webinar presented September 16, 2026 by the Colorado Health Institute and the Colorado Department of Health Care Policy and Financing, along with the official state pages linked above. Rules and timing can change as federal guidance is finalized, so please confirm details on the official pages before acting.

This page is general information only. It is not legal advice, immigration advice, or a determination of your eligibility for any program. Only the Colorado Department of Health Care Policy and Financing and your county eligibility site can decide your Health First Colorado eligibility. For immigration questions, please consult a licensed immigration attorney or an accredited representative.