For Coloradans on Medicaid, the 'beautiful' bill brings more worry
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DENVER — Jesse Ramsey had two children, a lucrative career as a welder and a job teaching welding at Lincoln College of Technology. He felt successful.
In 2019, Ramsey developed severe stomach aches. Bouts of nausea, cramps and digestive issues had him calling out of work — a rarity for Ramsey, who touts a strong work ethic — first monthly, then weekly, then almost every day.
He started seeing specialists in 2019. Doctors diagnosed Ramsey, 39, with Superior Mesenteric Artery syndrome in April of last year. SMA is a rare gastrointestinal disorder where a section of the small intestine becomes compressed between the abdominal aorta and the superior mesenteric artery. The compression can result in various digestive issues and can be fatal.
“The doctors couldn’t figure out what was wrong with me because those symptoms are so common,” Ramsey said. “But it got to a point where I couldn’t eat or drink anything and I’d be in the ER once a month.”
Ramsey said he was fired from his welding job after a series of medical-related absences. He and his two children, 5 and 7, moved into a Best Western in North Denver for two weeks before they were accepted into Lambuth Family Center, a Denver homeless shelter for families.
He’s had five surgeries since 2019, three bouts of kidney failure, two rounds of sepsis and three blood clots in his lungs. Because he has no income, Ramsey and his children are on Medicaid, a joint state-federal program that covers medical costs for lower-income Americans. If not for Medicaid, Ramsey estimates he’d owe about $1 million in medical debt.
President Donald Trump’s One Big Beautiful Bill Act, which he signed into law July 4, includes roughly $1 trillion in cuts to federal Medicaid spending and introduces work requirements for adults ages 19 to 64 deemed “able-bodied.” The legislation does not clearly define able-bodied, and Medicaid advocates warn that the new requirements could further complicate an already burdensome system.
Annie Lee, president and CEO of Colorado Access, the largest public sector health plan in Colorado, said the bill has left many patients confused about the future of their health care.
“We know from past experiences that when there are administrative processes layered onto how you can access the program and gain coverage and healthcare, it means loss of coverage,” Lee said.
The work requirement does not apply to parents with children 13 and under, which includes Ramsey. But despite the exemption, Ramsey still worries about health care access.
The federal government administers Medicaid funding to each state. States match the funding and enroll eligible patients into the program. Colorado spends more money on health care than any other budget item.
In 2018, Arkansas became the first state to require state residents on Medicaid to prove their employment. The next year, Harvard researchers found that the number of uninsured patients increased, but the number of people employed in the state did not.
“What you're talking about doing is putting pressure on people who are already struggling to navigate a very complex system to do more administratively,” Lee said.
According to the Colorado Department of Health Care Policy and Financing, about 1.46 million Colorado residents are enrolled in Health First Colorado (Colorado Medicaid,) and about 89,000 children are enrolled in Child Health Plan Plus. Axios reported an estimated 377,0000 patients are at risk of losing access because of the work requirements, and administrative costs to monitor employment status would cost the state about $57 million each year.
“People are going to get sick and they’re not going to be able to access care,” Lee said. “The bill doesn’t offer any kind of solutions for people who are going to lose healthcare.”
Lindsay Hawk said she worried this day would come once Project 2025, The Heritage Foundation’s blueprint for a second Trump term that prioritizes cuts to Medicaid, entered the political mainstream.
“We’d been preparing,” Hawk said. “But it was still really jarring to get the news.”
Hawk moved to Colorado from Oklahoma in 2022, hoping to find better treatment for a rare kidney condition that causes her to develop unusually large and aggressive Brushite kidney stones. Hawk said accessing Medicaid was difficult in Oklahoma. She also has a nonbinary child, and Oklahoma banned gender-affirming care for youth. The Hawk family wanted to move.
“We saw what was coming as far as the way they were coming after trans kids and also Medicaid,” Hawk said. “And I thought ‘I need to get my kids out of this state.’”
Hawk packed up her car with her two children — then 12 and 14 — and the four of them moved into a hotel in Denver’s Baker neighborhood. She couldn’t afford to pay hospital bills, so Hawk did whatever she could think of to manage her symptoms at home, like cannabis and herbal teas. When the pain became unbearable, she sought treatment at UCHealth, and the staff there helped enroll her in Health First Colorado.
Hawk, 42, can’t work due to her kidney issues. But before the stones started in 2019, Hawk was a Licensed Practical Nurse, and also worked in daycare centers and in retail.
She has applied for Social Security Disability Insurance three times and been denied each time. Hawk said the SSDI told her she “did not prove enough evidence of disability.” If she were approved, Hawk would be exempt from the work requirements signed into law.
The Trump administration’s bill provides an exemption for people considered “medically frail,” but historically, definitions of “frailty” have been left to the states, where definitions can be vague. Hawk does not know if she’ll qualify for the exemption.
“I'm f–ing terrified that I'm going to lose access to health care with the new cuts, because I know I’m going to die once I lose health care access,” she said.“It sucks because my kids and I thought we'd gotten through the period where they were going to have to sit and watch me die, and now we're not so sure.”
Because she couldn’t access Medicaid in Oklahoma, Hawk turned to what she described as at-home healers, people who brought her herbs and prayers. While Hawk said she is grateful for their work, being able to access licensed medical professionals in Colorado has been “life-changing.”
Hawk said her condition is considered a “medical anomaly,” because she’s able to pass her kidney stones even though they’re so large. UCHealth doctors are studying her kidneys and conducting tests to figure out if she is predisposed to certain cancers. She is trying to do as much testing as she can now before the cuts take effect in 2026.
Hawk spends her days gardening at her low-income apartment complex in Denver. She is growing eggplants, beets, lettuce, tomatoes, squash and flowers for her neighbors. One day, she hopes to sell her produce at a farmer’s market.
“My quality of life in Colorado is so much better because I have access to Medicaid and I don’t have to worry about going to the doctor,” Hawk said. “In Oklahoma, it would be the difference between paying your light bill and paying your medical bill and as a mother, of course the light bill is always going to win.”
Type of story: News
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.
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