An estimated 130,000 Coloradans are projected to lose their health insurance under Republicans’ signature “One Big Beautiful Bill Act,” or H.R. 1, according to a new Protect Our Care report.

State officials are speaking out against the law, which passed last summer and cuts more than $1 trillion from Medicaid and assistance through Affordable Care Act marketplaces such as Connect for Health Colorado over the next decade.

Lieutenant Governor Dianne Primavera said H.R. 1 is making health care harder to access and afford. She said Medicaid is a key safety-net program that many Coloradans need at some point in their lives.

“So despite the rhetoric that we hear out of Washington, D.C., these cuts don’t only impact the ACA expansion population," she said. "They also hit the traditional Medicaid programs for seniors, people with disabilities, pregnant women, and children.”

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H.R. 1 is expected to claw back $14 billion in federal Medicaid dollars from Colorado. Medicaid provides health coverage to one in five state residents.

The most substantial cuts are not set to take effect until after November’s midterm elections, but state officials have already had to cut Medicaid services and provider reimbursements.

Republicans have argued that cuts to Medicaid, which helped pay for extending the first Trump administration’s tax breaks, are necessary to curb fraud and waste and will not result in people losing health coverage.

Most of the Medicaid cuts are expected to come from additional work requirements, limits on how states can cover their share of costs, and increased barriers to enrolling in and renewing coverage, according to KFF Health News.

Primavera said even small administrative hurdles — such as a missed notice, confusing letter or renewal form — can cause eligible people to lose coverage.

“So unfortunately, H.R. 1 is riddled with bureaucratic hurdles that’ll make it harder and more confusing to get or keep the care that so many people need,” she said. “Not only does that delay care, but it forces us to spend money on paperwork rather than patients.”

An Urban Institute study finds H.R. 1 will leave hospitals with an estimated $280 billion in uncompensated care costs. The study says more than 900 hospitals nationwide, many in rural communities, are expected to close when people without insurance cannot pay their bills.

Republicans added $50 billion to help hospitals stay open, which is roughly a third of the federal Medicaid funding cuts in rural America.