How will caregiving count under Colorado's new Medicaid rules? "Depending on the circumstances."

At an Oct. 26 webinar on the new federal Medicaid work requirements, Colorado’s Medicaid director said whether family caregiving counts as an exclusion or as work will be decided “depending on the circumstances.” The rules start in January. And as our Director of Advocacy, Mark Fukae, writes, there’s no soft landing: someone who would qualify for Medicaid but misses the work requirement can’t get premium tax credits on the exchange either.

By Mark Fukae - Director of Advocacy - Professionals Who Care

Beginning in January 2027, many adults on Health First Colorado will need to show they work, volunteer, go to school or train for 80 hours a month. Family caregivers can be excluded. At its Oct. 26 webinar, the state's Medicaid director said caregiving "may be a specified exclusion under the rules, or may count as work... depending on the circumstances," and that more information is coming.

Here's what we know. HCPF says Colorado plans to accept a caregiver's signed statement in 2027. What proof will be needed in 2028 is still being designed. The federal rule says paid and unpaid caregivers are treated the same.

The stakes are financial as well as medical. AARP's new national study finds family caregivers of adults spend an average of $11,508 a year of their own money on care, 31% of household income, and working caregivers spend about $12,606.

For employers and HR professionals: some of your employees may soon need to document caregiving for Medicaid. A simple, private way to confirm their schedule or leave, if they ask, could help them keep coverage.

For caregivers: start a simple record now of the days and hours you give care. If 2028 asks for proof, you'll have it.

Read the full essay: [https://therevenueneutralcaregiver.substack.com/p/the-research-desk-6-depending-on?r=6a52ih&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true]