On May 22, the U.S. House of Representatives passed budget reconciliation package H.R. 1 — also known as the “One Big, Beautiful Bill Act” (BBB) — which includes hundreds of provisions, including trillions in tax cut extensions and slashed federal funding over the next 10 years. While the bill will face changes before it is passed by the Senate, many of its proposals as-written would significantly affect life in the Roaring Fork Valley.
Medicaid and SNAP
Many of the provisions within the BBB will make eligibility requirements for Medicaid and the Supplemental Nutrition Assistance Program (also known as SNAP and formerly referred to as food stamps) more stringent.
In the case of Medicaid, states will be required to double the frequency of Medicaid eligibility checks from once a year to once every six months. Additionally, a new work requirement would mandate that childless adults work, volunteer or attend school for 80 hours a month as a condition for enrollment, and U.S. citizenship will become a requirement.
A work requirement will also be introduced for SNAP eligibility. According to House Republicans, these new rules are designed to reduce fraud and waste.
Currently, SNAP and Medicaid require that an individual’s income not exceed a certain level in order to be eligible for benefits. While this income level varies state-by-state and adjusts based on the size of households, it does not adjust for the cost of living, which is significantly higher in Eagle, Garfield and Pitkin counties than elsewhere in the country.
By default, a livable wage in the Roaring Fork Valley will push most residents out of eligibility for SNAP and Medicaid, even if those individuals still struggle to afford food and health insurance.
Effects on local healthcare
Of all the government programs targeted by the BBB, Medicaid will be hit the hardest. The program, designed to provide health insurance to those with limited income, will lose around $600 billion in funding as eligibility requirements become more stringent. The Congressional Budget Office estimates around 10.9 million people nationwide could lose Medicaid coverage as a result of BBB provisions. Accessible healthcare will be affected for residents in the Roaring Fork Valley — insured and uninsured alike.
Mountain Family Health Centers (MFHC) operates several integrated health centers designed to provide quick, accessible health services such as medical, behavioral and dental care across multiple counties. Within the Roaring Fork Valley, MFHC operates integrated health centers in Basalt and Glenwood Springs, as well as school-based centers in Glenwood High School and Roaring Fork High School.
Due to the high cost of living in the Roaring Fork Valley, more MFHC patients are uninsured than enrolled in Medicaid. Without Medicaid, MFHC cannot receive federal reimbursement for providing care, which would drastically reduce revenue — and has already in the past.
In 2023, a mass redetermination of Medicaid eligibility led to a $1.5 million loss in MFHC’s annual revenue, which drove the provider to lay off staff and close its health centers in Basalt Middle and High schools.
According to MFHC’s CEO Dustin Moyer, it’s hard to say which of MFHC’s services will be next on the chopping block when the new Medicaid provisions take hold. Either way, further reduction in revenue as a result of the BBB as-written means further healthcare service reductions.
Food Security
Like with Medicaid, most Roaring Fork Valley residents are ineligible for SNAP due to the high cost of living. Because of this, hunger is often addressed by partnerships between local governments and food security nonprofits. In Pitkin County, only around 250 residents use SNAP. However, far more residents rely on grant-funded nonprofits like Lift-Up to feed themselves and their families.
While the BBB will increase eligibility requirements for SNAP, it will also reduce federal funding for the program by requiring states to pay for 5% of food benefits which are currently funded in full by the federal government starting in 2027. This portion will increase in size proportionate to the rate of erroneous payments in the state’s last fiscal year. Also, effective immediately on the bill’s passage, federal administrative costs for SNAP would be reduced from 50% to 25%, increasing state costs by 25%
This requirement will place strain on state and local budgets operating under a public benefits methodology which, according to Pitkin County Human Services Director Lindsay Maisch, has been identified as underfunded “for quite some time.” Additional eligibility requirements and doubling evaluations will place clerical strain on these already underfunded state offices.
Maisch said that as we travel into a possible recession and as federal funding disappears, both nonprofits and government offices will bear the impact, and it is likely that county governments in Colorado may have to cover the portion of benefits required by the BBB, necessitating some tough decisions on where to direct local funding. “It’s going to impact all of us,” Maisch said. “It’s looking grim out there.”