Colorado’s Democratic leaders defend steep drop in Medicaid enrollees
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Colorado defended its high Medicaid disenrollment rates after COVID by saying that what goes up must come down. Advocates and researchers disagree.
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Colorado stands out among the 10 states that have dropped the highest share of Medicaid enrollees since the U.S. government lifted a pandemic-era restriction on removing people from the health insurance program.
It’s the only blue state in a cluster of red states with high withdrawal rates – a group that includes Idaho, Montana, Texas, and Utah – in the Medicaid “unwinding” underway since spring 2023.
Colorado also is the only state that had all the policy ingredients in place to cushion the fallout from the unwinding, according to Medicaid policy analysts at KFF, an independent nonprofit that conducts health policy research.
But it seems the cushion hasn’t been deployed.
“There’s really a divide in Colorado between our progressive policies and our underfunded and fragmented administration,” said Bethany Pray, chief legal and policy officer at the Colorado Center on Law and Policy, a Denver-based legal aid group.
According to KFF data, during the unwinding Colorado has seen a bigger net drop in enrollment in Medicaid and the Children’s Health Insurance Program than any state except Utah.
Advocates for health care access, researchers, and county administrators – the administrators handling the bulk of the Medicaid redeterminations in Colorado – say that the major issues involve outdated technology and low rates of automatic renewals. Both create obstacles to enrollment that undercut the state’s progressive policies.
State officials have a rosier view. They say the drop in enrollment is a sign that they did a good job enrolling people at the height of the COVID-19 pandemic. Secondly, they say Colorado’s economy is doing well, so more people can get insurance through their jobs.
“When we have a really stellar unemployment rate, not as many people need safety-net programs, and we’re proud of that. Our people are rising and thriving,” said Kim Bimestefer, who leads the Department of Health Care Policy and Financing and is the state’s top Medicaid official. Her department has also said that some people choose not to fill out their eligibility paperwork because they know their incomes are too high to qualify.
Bureau of Labor Statistics data shows that while it’s true Colorado’s unemployment rate is lower than the nation’s as a whole, it’s higher than it was before the pandemic.
State officials say they believe Medicaid enrollments dropped because many of those people found jobs, as reflected by the lower unemployment rates. But that scenario happened in fewer than half of the state’s counties, a KFF Health News analysis found. Notably, in 11 counties where unemployment stagnated or increased from January 2020 to April 2024, the share of the population covered by Medicaid shrank. A low unemployment rate does not necessarily mean there is…
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