Important changes are coming to Health First Colorado (Colorado’s Medicaid program). New federal rules will affect some adults ages 19 to 64 and some immigrants who get Health First Colorado or Child Health Plan Plus (CHP+).
You are likely not affected if you are:
- A child (0 to 18)
- An adult age 65 or older
- A qualified Health First Colorado or CHP+ member who is pregnant or was pregnant in the last 12 months
- Enrolled in long-term services and supports (LTSS) or buy-in programs
On this page
— Immigrants
— Adults (19 to 64) not enrolled in LTSS or buy-in programs
— What you should do now
Related
— Work requirements screening tool
— FAQs: Medicaid changes 2026-2027
Immigrants
Starts October 1, 2026
Immigration status change
Starting October 1, 2026, only certain lawfully present immigrants can qualify for Health First Colorado or CHP+.
These immigrants will still qualify:
- Green Card holders
- Certain Cuban or Haitian immigrants
- Citizens of the freely associated states (COFA migrants), and
- Lawfully present children and pregnant people
Members of the Cover All Coloradans program will continue to qualify for Medicaid and CHP+.
These immigrants may no longer qualify for Health First Colorado:
- A refugee or asylee: someone who left their home country for safety and don't yet have a Green Card.
- A humanitarian parolee: someone allowed into the U.S. for urgent reasons for at least one year.
- A survivor of domestic violence or human trafficking, and you have a pending status.
What you can do now
- Check this website and your mail for details on how this policy will be implemented in Colorado.
Adults (19 to 64) not enrolled in LTSS or buy-in programs
August 2026
Letters mailed to Health First Colorado members affected by work requirements
In August 2026, Health First Colorado will mail letters to members who must complete work requirements, also known as community engagement requirements, to keep or receive their health coverage.
November 2026
Letters mailed to Health First Colorado members with January renewal dates
In November 2026, Health First Colorado will mail letters to members with a January 2027 renewal date. If a member is subject to work requirements, they will have to show that they comply or meet an exemption to keep or receive their health coverage.
Starts January 1, 2027
Work requirements
Starting January 1, 2027, adults ages 19 to 64 not enrolled in a LTSS or buy-in program must meet the work requirement when applying for or renewing their coverage. If this rule applies to you, Health First Colorado will send you a letter.
Who must comply with work requirements:
Adults ages 19 to 64 who are applying for or renewing their coverage who
- Are not enrolled in LTSS or buy-in program, and
- Do not show that they meet any of the exemptions listed directly below
Who does not need to comply with work requirements:
Age
- Children age 18 or younger
- Adults age 65 or older
Caregivers
- Parents, guardians or caregivers of a child age 13 or younger
- Parents, guardians or caregivers of a person of any age with a disability
Living situation
- People who are in jail, prison, or other correctional facility now or in the past 3 months
Pregnancy
- Current qualified Health First Colorado or CHP+ members who are pregnant or were pregnant in the last 12 months
Medical conditions
- People enrolled in a LTSS or buy-in program
- People who are blind
- Veterans with a total and permanent, service-connected disability
- People who are medically frail. A medically frail person has significant health needs, such as a disabling mental health condition, substance use disorder, or other complex medical condition that limits daily functioning or requires ongoing medical care.
- A person in treatment for or in rehab for mental health or substance use disorder
- People who are enrolled in or qualify for Medicare
Population
- Most American Indians or Alaska Natives
- Former foster youth age 19 to 26
How to complete the work requirements if they apply to you
You can comply with work requirements by either completing 80 hours of approved activities or earning at least $580 from paid work.
- First time applicants, in the calendar month before they submit their application, will need to show that they
- earned at least $580, or
- spent at least 80 hours working, going to school, job training, participating in a work program, volunteering, or a combination of these activities
- Current members who are renewing, for at least 1 of the months within their 6-month renewal period, will need to show they
- earned at least $580 or
- spent at least 80 hours, going to school, job training, participating in a work program, volunteering, or a combination of these activities
What activities count towards meeting the work requirement
Complete 80 hours of one (or a mix) of the following activities:
| Category | Example |
|---|---|
| Work |
|
| School or training |
|
| Community engagement |
|
⚠️ If you do not meet these requirements or renew on time, you may lose your health coverage.
What you can do now
- Please respond to any letter that asks for more information by the deadline in the letter.
- Make sure your address and contact information is always up to date. Contact your county or update your information on the Health First Colorado app or at CO.gov/PEAK.
- Keep all your other household information up to date. Contact your county or update your information on the Health First Colorado app or at CO.gov/PEAK.
6-month renewals for some low-income adults
Starting January 1, 2027, some adults ages 19 to 64 will have their eligibility checked every six months instead of once a year.
Who must comply with 6-month renewals:
- Adults (age 19 to 64) who earn up to 133% of the federal poverty level (up to $20,815 per year for a single individual or $42,760 per year for a family of four).
⚠️ If you do not renew on time, you may lose your health coverage.
Who does not need to comply with 6-month renewals:
- Most American Indians or Alaska Natives
What you should do now
- Watch your mail for a letter from Health First Colorado
- Open and respond to letters right away
- Update your contact information to avoid missing notices

