To Sens. Michael Bennet and John Hickenlooper and Reps. Jeff Hurd and Joe Neguse:

I am writing to you on behalf of Mountain Family Health Centers and the 20,000 Coloradans who utilize our health care services. Mountain Family operates eight clinic locations in Garfield, Eagle, and Pitkin counties. We address the needs of our patients and our community by providing sophisticated, whole-person care with an integrated health model. Our patients have access to medical, dental, behavioral, and pharmacy care, with all four services available at all our health care sites. We also employ enrollment specialists and care coordinators who work to ensure our patients can access health insurance coverage and support our patients navigating housing or food insecurity. 

I am reaching out to respectfully urge you to reject HR 1, the “One Big Beautiful Bill.” I view this legislation as deeply concerning to Mountain Family and the patients we serve, especially those patients who rely on Medicaid to access life-saving care. 

The communities we serve have higher rates of uninsured than most communities in Colorado. This is primarily driven due to the high cost of living where many of our patients are working jobs whose salary is greater than the 138% Federal Poverty Level threshold for Medicaid eligibility ($44,367 for a family of four). Many of these patients are employed in the service industry, where employer-sponsored insurance isn’t available and the high cost of health care drives premium costs to unattainable levels. The provisions contained within H.R. 1 will only put health care coverage further out of reach for communities who have limited coverage options. 

I am particularly concerned about the work requirement provisions contained within the legislation. While these policies make sense in theory, in practice they appear to be a solution in search of a problem, ninety two percent of all Medicaid enrollees are employed, disabled, a student, or a caregiver. These requirements will require an unprecedented increase in administrative capacity to implement. The Colorado Department of Health Care Policy and Financing estimates these provisions would cost the State of Colorado $57 million and require 3,700 new case managers. 

The impact on Medicaid-covered individuals would be equally catastrophic, the work requirement provisions, and bi-annual Medicaid eligibility checks will only add to the administrative burden patients must navigate to ensure continuous coverage. The result of these additional hoops will be that coverage will come further out of reach for communities where coverage is already extraordinarily difficult to access. If this bill passes, over 300,000 Coloradans are predicted become uninsured over the next 10 years, through loss of Medicaid and Marketplace coverage. Many will become uninsured because of the new confusing paperwork and added costs, not because they are ineligible. 

There was a recent report published by the Brookings Institute that anticipated these provisions would disproportionately harm employees in the service industry. The service sector is an economic driver in the rural/resort communities that we serve and those employees who drive our economy would be the hardest hit. 

When these patients lose Medicaid coverage, Mountain Family will continue to provide these services. Yet, the growing number of uninsured patients we care for has already put our sustainability into serious question. During Colorado’s Medicaid unwind, 2,000 Mountain Family patients lost Medicaid coverage. This coverage loss translated into a $1.5 million loss in revenue which resulted in layoffs and clinic closures. If the cuts included in H.R. 1 are passed, we face more layoffs and clinic closures. 

I am also concerned about the change to ACA exchanges, which will impact Colorado’s state-based Marketplace, Connect for Health Colorado, and the many Coloradans who rely on it to access more affordable commercial health insurance. Altogether, the changes in the bill could result in a potential loss of coverage for 112,000 Coloradans or 43% of the state’s marketplace customers. As referenced previously, health care coverage is very difficult to access in the communities that Mountain Family serves. 

By removing the year-round special enrollment period for people with incomes up to 150% of the federal poverty level and shortening the general open enrollment period for all applicants, fewer people will have the opportunity to enroll and it will increase the workload of enrollment teams. 

Changes to “silver loading” on exchange plans will mean that Coloradans see their average premiums increase by 39%. It is estimated that 23,000 enrollees would drop their coverage due to the increased costs. New verification requirements will also result in delays in financial help for thousands of Coloradans. These provisions only serve to further restrict access. 

Thank you, each, for your commitment to Colorado’s communities. I respectfully urge you to reject H.R. 1 and the provisions that would further restrict health care coverage to Mountain Family’s patients and the citizens of Colorado. 

Dustin Moyer is CEO of and a patient at Mountain Family Health Centers and lives in Glenwood Springs with his family.