Medicaid Changes

Man with a prosthetic leg sitting on stairs inside his apartment and looking away from the camera.

Updated June 15, 2026

Starting January 1, 2027, a new federal law will require some adults from age 19 to 64 to comply with work requirements to keep or get Health First Colorado (Colorado’s Medicaid program).

  • To comply, these adults will need to complete and report that they worked, volunteered or attended school at least 80 hours in a month or earned at least $580 from paid work.
  • People can also complete a combination of these activities to comply. 

⚠️ People who do not comply with work requirements or renew on time will lose their health coverage.

  • Some adults age 19 to 64 will also need to complete their renewals every 6 months instead of once a year. [Learn more about 6-month renewals.]

If this rule applies to you, Health First Colorado will send you a letter in the fall of 2026.

You are likely not affected if you are:

On this page:

— Who must comply with work requirements

— Who does not need to comply with work requirements

— How to comply with work requirements

— Activities that count

— Additional resources

— FAQs and resources

Who must comply with work requirements

Adults ages 19 to 64 who are applying for or renewing their coverage who

  • Are not enrolled in LTSS or buy-in programs, and
  • Do not show that they comply with any of the approved reasons listed directly below

Who does not need to comply with work requirements

Age

  • Children 18 or younger
  • Adults 65 or older

Caregivers

  • Parents, guardians or caretaker relatives or family caregivers for a child 13 or younger
  • Parents, guardians or caretaker relatives or family caregivers responsible for caring for a person of any age who has a disability

Living situation

  • People living in a jail, prison or some halfway houses, now or in the past 3 months
  • People living in a hospital, nursing home or other long-term care facility now or in the past three months

Pregnancy

  • Current Health First Colorado members who were pregnant within the last 12 months, or are currently pregnant

Medical conditions (updated August 4, 2026)

  • People enrolled in a LTSS program
  • People enrolled in Medicaid  buy-in programs (Working Adults or Children’s)
  • People living with a drug or alcohol use disorder that prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People in recovery from a drug or alcohol use disorder for 5 years or less that prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People living with a physical, intellectual, or developmental disability that makes it hard to do daily activities and that prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People living with a disabling mental health disorder that prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People living with a serious health condition that requires regular treatment that prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People who are blind and their condition prevents them from completing 80 hours per month of work, school, and/or volunteer activities
  • People receiving long-term care services (for example, in a nursing home or through home-based care)
  • People receiving Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI)
  • People who qualify or are enrolled in Medicare

Population (updated August 4, 2026)

  • American Indians and Alaska Natives (AI/AN) who are eligible for Indian Health Services (IHS), a Tribal Health program, or an Urban Indian Health program; or who have received services from Indian Health Services (IHS), a Tribal Health program, or an Urban Indian Health program, now or in the past
  • People who were in foster care when they turned 18 and who are now between ages 19 and 26
  • A veteran with a service-connected disability that the U.S. Department of Veterans Affairs (VA) has determined to have either a 100% disability rating (temporary or permanent); or a Total Disability based on Individual Unemployability (TDIU), even if your combined disability rating is below 100%

How to comply with the work requirements 

You can comply with work requirements by either completing 80 hours of approved activities or earning at least $580 from paid work or a combination of these.

  • First time applicants: In the calendar month before they submit their application, will need to show that they
    • earned at least $580, or
    • spent at least 80 hours working, going to school, participating in a work program, volunteering, or a combination of these activities
  • Current members who are renewing: In at least 1 calendar month since their last renewal deadline, will need to show that they
    • earned at least $580 or
    • spent at least 80 hours, going to school, participating in a work program, volunteering, or a combination of these activities

Activities that count towards complying with the work requirements

Complete 80 hours of one (or a mix) of the following activities:

Category Example
Work
  • Paid work
  • Self-employed
  • Seasonal work
School or training
  • Participating in a work program
  • Going to college, community college or a GED program at least half-time
Community engagement
  • Volunteering

Additional resources

FAQs and resources