Colorado Prepared and Protected

April 28, 2026

A partnership between the Colorado Health Institute and the Colorado Cross-Disability Coalition, made possible by a grant from the WITH Foundation.

In July 2025, Congress passed H.R. 1, which makes significant changes to Medicaid. Starting in January 2027, many adults on Medicaid will be required to report work, job training, or volunteering to keep their coverage. People who are enrolled in Medicaid through a disability-specific category are exempt — but many Coloradans with disabilities may be subject to the new requirements because they are not formally enrolled in an exempt category.

For people with cognitive disabilities, navigating this process can be an even bigger barrier than it is for others — not because they are ineligible, but because the process itself is hard to get through. We are working to make sure no one loses coverage simply because they couldn't get through the paperwork.

What We're Doing

This is a short-term project with a clear deadline: January 2027. Here is how we are spending that time.

Outreach — We are connecting directly with people who may be affected and working through community partners to spread the word.

Exemption Support — We are helping develop tools that providers and supporters can use to apply for exemptions for people who qualify. We are also building resources to help providers navigate the process on behalf of their clients.

Plain-Language Resources — We are creating materials that explain the new rules, what they mean, and what people can do in language that is easy to understand.

Policy Advocacy — The Colorado Cross-Disability Coalition is also making sure that the needs of people with cognitive disabilities are considered as these rules are written and implemented.

Who This Project Serves

Not everyone with a cognitive disability has gone through a formal disability determination process. If you are on Medicaid through SSI, Medicaid Buy-In for Working Adults with Disabilities, or a Home and Community Based Services (HCBS) waiver program these rules do NOT apply to you. However, many Coloradans with these conditions are enrolled in Medicaid through the general expansion category, which means the new requirements apply to them. If you filled out an application and got Medicaid quickly, are not on SSI or SSDI, and did not do a longer “disability determination” process to get Medicaid, you are probably in the expansion category.

This project supports Coloradans who have difficulty with tasks like reading, filling out forms, remembering steps, staying organized, or using technology. This can include people living with:

Autism or ADHD
Learning disabilities
Mental illness
Chronic illness
Brain injury
Medication side effects

Frequently Asked Questions

What are the new work reporting requirements?
Under H.R. 1, most working-age adults on Medicaid will need to regularly report that they are working, looking for work, in school, or doing volunteer or caregiving activities. If they do not report this or do not qualify for an exemption, they could lose their coverage. The reporting process involves forms, deadlines, and follow-up steps, which is exactly where people with cognitive disabilities can run into serious trouble.

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Why might someone with a cognitive disability not be exempt from the new requirements?
Medicaid has categories specifically for people with disabilities, but getting into those categories requires going through a formal determination process. That process can be hard for people with cognitive disabilities, especially without support. Many people end up enrolling through Medicaid, which is simpler but does not include an automatic exemption from the new requirements.

Why does this group need a dedicated effort?
Without a focused effort, people who already struggle with complex processes tend to be overlooked. We know from experience that if there is not a dedicated effort to reach this community, they simply get left behind, not because of lack of eligibility, but lack of support.

Is there a deadline?
The new work reporting requirements are expected to take effect in January 2027. That gives us time to prepare, but not a lot of it.

This project is a partnership between the Colorado Health Institute and the Colorado Cross-Disability Coalition, made possible by a grant from the WITH Foundation.

Feds Issue Guidance on Medicaid Work Requirements

Learn more about Medicaid work requirements in Colorado.

Use the Work Requirements Screener tool to understand if you may be affected by new Medicaid work requirements.

Get Involved.

We are looking for people with lived experience and professionals who work with people with cognitive disabilities to help guide this project.

Whether you want to stay informed or play an advisory role, we want to hear from you.

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