REGIONAL: San Miguel County commissioners draft a letter opposing changes to Medicaid; Proposed legislation could eliminate health care coverage for 7.6 million people

Medicaid is back on the chopping block with President Donald Trump's new proposed legislative package, but the San Miguel Board of County of Commissioners (BOCC) are doing what they can to express their support for maintaining Medicaid programs.

The Congressional bill lumps together tax breaks, spending reductions and increased border security funding. With the $900 million in proposed reductions to spending, much comes from existing Medicaid programs. Republicans claim to be eliminating "waste, fraud and abuse," but Democrats warn that these cuts come at the cost of millions of Americans losing health care coverage.

During a BOCC meeting on Wednesday, May 14, the commissioners discussed a draft of a letter, to be approved next week, opposing proposed changes to

Medicaid eligibility. Congressman Jeff Hurd, who represents Colorado's 3rd district, including San Miguel County, joined several other Republican representatives in opposition to a federal budget that includes cuts to Medicaid.

"We were fortunate that our representative for congressional district 3, Jeff Hurd, spoke up along with 11 other Republican congresspeople and let the leadership know that they would not support any kind of a budget going forward that cut Medicaid benefits for vulnerable populations," Commissioner Anne Brown said. "That doesn't mean that Medicaid won't be cut, and in fact, they're now kind of getting into the nitty gritty of that conversation."

In April, Hurd and several other members of Congress wrote a letter to Speaker Mike Johnson and other Republican leaders in the U.S. House of Representatives stating that they would vote against any budget bill that cuts Medicaid support for their constituents.

"As Members of Congress who helped to deliver a Republican majority, many of us representing districts with high rates of constituents who depend on Medicaid, we would like to reiterate our strong support for this program that ensures our constituents have reliable healthcare," the representatives wrote in the letter. "We cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations."

The 3rd congressional district has Colorado's highest percentage of residents who depend on Medicaid, with over one-third of Hurd's constituents enrolled in the health care program, according to the Colorado Department of Health Care Policy and Financing. San Miguel County sits below the district's average, with 20% of residents on Medicare.

An estimate from the nonpartisan Congressional Budget Office expects the proposed changes to Medicaid would eliminate health care eligibility for 7.6 million people in the United States.

In the letter, the representatives also highlighted the dangers of hospitals closing that depend on Medicaid funding, especially in rural zones.

"Many hospitals — particularly in rural and underserved areas — rely heavily on Medicaid funding, with some receiving over half their revenue from the program alone. Providers in these areas are especially at risk of closure, with many unable to recover," the letter read.

Before the representatives spoke out in opposition to Medicaid cuts, the BOCC had sent a letter to Hurd outlining how budget cuts are affecting the county. An estimated $186,000 in federal funding has so far been cut and millions are currently frozen in San Miguel County in 2025 due to the Trump administration's new policies.

Changes to Medicaid can negatively impact the rural medicine system as a whole. San Miguel County has two small medical clinics, which serve about 8,000 residents and tens of thousands of visitors annually.

Both of the clinics are currently financially stable, but the operating margins are "razor thin," and any further reductions in funding, including to Medicaid could strain local resources.

Another of the proposed changes to Medicaid would require Medicaid Redeterminations — a review of coverage eligibility — to be conducted twice annually.

"Health insurance policies tend to renew annually, and that is the way Medicaid has traditionally worked. A big issue here is setting up a hurdle to people who are applying because now it takes two rounds of applications," Brown said.

Requiring eligibility checks twice per year would also increase administrative costs for the state and local counties.

Since proposed Medicaid changes are currently under review in Congress, the commissioners plan to approve the letter during Wednesday's regular meeting so it can be sent as soon as possible.

This story was originally published by the Telluride Daily Planet.