What started as a middle-of-the-night massacre to Medicaid, Medicare, SNAP (Supplemental Nutrition Assistance Program, aka food stamps) and other safety night provisions finished as a razor-thin vote in the U.S. House. The bill passed 215-214 (some members abstained or slept through the vote) with the assistance of every Republican from Colorado’s congressional delegation.
It will hurt people across the state and may outright kill some.
For example, Medicaid covers 1.2 million Coloradans. It pays for indigent care, those who are disabled and seniors living in long-term care facilities. While Medicaid pays health care providers significantly less than either private insurance or Medicare, it remains a critical reimbursement source for hospitals and care clinics. The bill will have a cascading effect on the entire state economy.
The initial impact will be directly to patients. Losing health care coverage leads to multiple negative outcomes. People previously covered will avoid seeking care until otherwise easily treated illnesses become catastrophic emergencies. When a hospital admission becomes necessary, families already struggling to make ends meet will be overwhelmed by medical bills. That means debt collections and bankruptcies will spike.
Hospitals, particularly rural hospitals, will be the next victims. Most rely on Medicaid reimbursement to keep their doors open. That is only exacerbated by a potential flood of patients to emergency rooms — who cannot legally turn away anyone unable to pay — as uncovered individuals arrive sicker because they avoided an earlier, less costly visit to a non-emergency provider.
Significant cuts make ongoing viability impossible. One study found 300 rural hospitals across the country will be at “immediate risk of closure.” After two decades in decline, access to those communities could be wiped out. Some people will need to drive hours to receive emergency care.
That means a heart attack or car crash in rural Colorado is much more likely to be deadly.
And that is before considering the impact on seniors. They will take a double whammy. Medicaid pays for skilled nursing — Medicaid covers about two-thirds of all nursing home residents in the state. Couple that with a $500 billion cut to Medicare, the country’s primary health care coverage for seniors, and many older Americans will become collateral damage.
Such unpopular cuts should be political suicide for Republicans.
Nowhere is that more true than in the two most competitive congressional districts in the state. Reps. Gabe Evans, in the 8th Congressional District, and Jeff Hurd, in the 3rd Congressional District, both voted to gut programs that disproportionately help their constituents. Evans represents a district where 29% of the population receives health care through Medicaid. The only district with a greater percentage is Hurd’s with 31%.
Whatever pressure brought on them to secure their votes, it may cost both their political careers. Tens of thousands of people in each district will likely see their health care purged. Evans won his seat by less than 2,500 votes; Hurd had a relatively more comfortable nearly 20,000. Both could be swamped by this vote, especially when compounded with rising prices and a flagging economy under Trump’s tariffs.
Should 2026 turn into a Democratic wave-election, much like Republicans had in 2010, Evans would be one of the first candidates sacrificed by a national party looking to stem the bleeding. That is particularly true since he already has three strong challengers: Yadira Caraveo, who previously represented the district and lost a narrow race to Evans last year; State Rep. Manny Rutinel, who has already raised more than $1 million; and State Rep. Shannon Bird, who served on the state’s Joint Budget Committee.
Whether Adam Frisch, who chased Rep. Lauren Boebert out of the Western Slope after almost beating her in 2022 before he lost to Hurd in 2024, gets in the race or not, a severely hobbled Hurd will likely attract a well-funded opponent. Any opponent will be able to use this bill like a club.
After signing a letter to protect Medicaid in April, Hurd flip-flopped in the end. That will have dire consequences in a sprawling, mountainous community. For example, the district includes the San Luis Valley, where two in five residents rely on Medicaid. Health care services will be cut, and the hospital, the largest employer in the valley, would be crippled.
Maybe Evans and Hurd chose to gamble that the U.S. Senate will save them by rejecting the bill. It already has significant opposition among GOP senators, and not just among usual suspects like Sens. Lisa Murkowski, R-Alaska, and Susan Collins, R-Maine. Sen. Rand Paul, R-Kentucky, has already said he is a “no;” Sen. Josh Hawley, R-Missouri, wrote an op-ed calling cuts to Medicaid “both morally wrong and politically suicidal.”
Or maybe they think that constituents will forget their votes by the time the election rolls around. After all, unlike the Affordable Care Act (aka Obamacare) which became law in March of 2010 during an election year, the next time voters get a say is 18 months away. Evans and Hurd may believe their constituents’ attention span will not be that long.
Whatever the future holds for those congressmembers, the vote last week points to an America that is less compassionate and less healthy. A country where the sick and the poor and the old can no longer count on their government to help them in their moments of greatest need.
Mario Nicolais is an attorney and columnist who writes on law enforcement, the legal system, health care and public policy. Follow him on BlueSky: @MarioNicolais.bsky.social.
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