Trump’s New Work Requirements Push Overwhelmed Counties to the Brink
In the remote mountain town of Silverton, Colorado—population 620—one woman is now responsible for enforcing a sweeping federal overhaul of Medicaid and food stamp eligibility. Krissy Rhoades, the sole staffer at the San Juan County Department of Social Services, faces a daunting task: implementing President Trump’s complex new work requirements that could strip benefits from thousands across rural America.
What’s in Trump’s Medicaid Overhaul?
The One Big Beautiful Bill Act, passed by Congress in summer 2025, mandates that adults without children under 13 must prove they work at least 80 hours per month to qualify for Medicaid or SNAP (food stamps). The law is projected to cut:
- $317 billion from Medicaid over 10 years
- $69 billion from food assistance programs
- Affect an estimated 7 million low-income adults nationwide
States Pass the Buck—Counties Bear the Burden
While the federal government designed the policy, it left implementation to states—and states like Colorado have delegated enforcement to already-strapped county offices. In rural counties, this often means:
- One or two staff handling eligibility, renewals, and compliance
- No IT upgrades to manage new verification systems
- Longer wait times and higher error rates for vulnerable residents
Impact by the Numbers
| Program | Projected 10-Year Cuts | New Work Requirement | Exemptions |
|---|---|---|---|
| Medicaid | $317 billion | 80 hrs/month work or community service | Parents of children under 13, disabled, elderly |
| SNAP (Food Stamps) | $69 billion | Same as Medicaid | Same as Medicaid |
“It’s Just Me Up Here”
“It’s a little stressful,” Rhoades admitted from her office in Silverton’s historic courthouse. She must now verify employment, track hours, process appeals, and manage re-enrollments—all without additional staff or funding.
Advocates warn the policy will disproportionately impact rural, elderly, and disabled populations who may lack internet access or transportation to meet documentation demands.
For more on how welfare policy affects local governance, see our feature on [INTERNAL_LINK:medicaid-work-requirements].
