Lilly Boyd Smith is a 30-year-old single mom of three living in Boulder. She relies on Medicaid and Planned Parenthood for her health care.
But when a provision in the Republicans' federal spending bill – known as the One Big, Beautiful Bill Act – blocked Planned Parenthood from receiving Medicaid reimbursements, she feared she’d lose her care.
"I felt a mix of panic and disbelief,” Smith said. “It definitely felt like the rug was being pulled out from under me. I was just like, ‘What do you mean? What's going on? How can this even be happening?’”
Smith had just undergone a medication abortion. Days after the federal bill was passed, she started hemorrhaging and couldn’t get the follow-up care she needed.
"So, I called Planned Parenthood, and I was told that they could no longer see Medicaid patients,” Smith said. “It was horrible. I was trying to figure out another place to go. Basically, I was forced to monitor my symptoms at home.”
Her experience, unfortunately, isn’t unique.
That’s according to Adrienne Mansanares, president and CEO of Planned Parenthood of the Rocky Mountains. The organization sees more than 10,000 Coloradans on Medicaid every year.
Mansanares says they had to cancel thousands of appointments across the state and turn away patients who rely on Medicaid immediately after the big, beautiful bill became law.
And it wasn’t abortion services that were affected. By law, federal funding can’t be used for that. Instead, Congress targeted basic reproductive and sexual health care, including transgender hormonal therapy.
“What President Trump signed into effect was, in a practical sense, a defund of Planned Parenthood.”Adrienne Mansanares, president and CEO of Planned Parenthood of the Rocky Mountains.
“Birth control, sexually transmitted infection testing and treatment, cervical and breast cancer screening, annual exams, pap smears,” Mansanares said. “What President Trump signed into effect was, in a practical sense, a defund of Planned Parenthood.”
Mansanares says Democratic lawmakers' bill that passed during the special legislative session gives patients a safeguard – ensuring Planned Parenthood is reimbursed with state dollars if federal funds disappear.
The funding has been cut off, a move affirmed by a federal appeals court earlier this month, which triggered the new state law.
But fear and confusion remain.
"Our patients across the state are scared,” Mansanares said. “They don't know if they can still access care at Planned Parenthood. We're still receiving calls every day from patients asking if their Medicaid is accepted.”
Republicans oppose the law. Rep. Dusty Johnson of Fort Morgan says it's misleading and directs scarce resources to one provider at the expense of others.
"When you're putting one entity that only serves most of, you know, urban and city areas... you're picking a high population area over rural populations,” Johnson said.
Johnson cites Planned Parenthood’s role as an abortion provider, whether federal dollars fund that or not.
“I also think it's very concerning when we put taxpayer dollars to entities that are doing things that aren't the basic needs, aren't the necessity needs,” Johnson said. “We're choosing an entity that is blatantly known for doing things like abortion, specifically."
She adds that Colorado shouldn’t backfill federal funding.
But Rep. Jenny Willford, a Northglenn Democrat and one of the bill’s sponsors, disagrees, and doesn’t “see a scenario in which covering the cost of Medicaid patients at Planned Parenthood is going to break the state budget.”
Without the law, Willford says taxpayers would still end up footing the bill.
"If people don't have access to Medicaid, and they don't have access to Planned Parenthood, they're going to show up in other places,” Willford said.
Health policy expert Alina Salganicoff says Colorado is the first state to step in with its own funding so Medicaid patients can keep using Planned Parenthood.
“Colorado really is on the front edge of the states,” Salganicoff said. “There have been discussions in other states about this, but I think it's just very few states. Washington State is one. I understand that there are also conversations in California.”
But Salganicoff questions if state-by-state fixes will hold over time.
"It is not a sustainable solution, because some years, some states will have good budgets, and some years they won't,” Salganicoff said. “So, that really puts health care services at Planned Parenthood competing with the basic functioning of state governments.”
For now, the new state law is a relief for the millennial Mom of three, Lilly Boyd Smith. She says it makes her feel seen by leaders who recognize the stakes, but the continued uncertainty is exhausting.
Smith wants people to understand what patients like her – low-income, uninsured, working women – really need.
“When I go to Planned Parenthood, I'm not making a political statement,” Smith said. “I'm just trying to get the care I need to stay healthy, you know, so that I can be the best mom I can for my kids.”
