Did you know more than 131,000 Colorado kids lost health coverage between May 2023 and January — many because of bureaucratic red tape and administrative errors? That’s the equivalent of every child in Denver County becoming uninsured in less than a year.
Throughout the pandemic, the federal government made it easier for people to get and keep Medicaid coverage. However, as the public health emergency declared in the early days of the pandemic has ended and those protections have been dropped — a process referred to by public health insiders as the “unwind” — an alarming number of people across the country are losing health coverage. A significant share of them are kids.
Having access to health coverage is important for everyone, but it is particularly vital for children. The American Academy of Pediatrics recommends 15 office visits by the time a child turns 6 years old. That’s not including care for the other illnesses and injuries that come up in the course of childhood. Health coverage helps families get the care they need, and the Colorado Children’s Campaign believes that every child and family in our state should have access to affordable and high-quality health care coverage.
But children across our state who are still eligible for Medicaid have been losing coverage in recent months at a pace we have never seen before. Families are getting confusing letters, spending hours waiting on the phone, or attending their regular doctors’ appointments only to discover they incorrectly lost their health care.
Without Medicaid, many of these children’s families cannot afford necessary health care services. They may delay essential medical care, struggle to afford their prescriptions, or take on overwhelming medical debt to get expensive emergency care that could be avoided with ongoing medical visits and affordable medications.
Colorado has taken steps to respond to this issue, including automatically renewing coverage for people with no income and giving people more time to reenroll. In April, the state will begin automatically reenrolling people with incomes below 100% of the poverty line.
While we applaud the efforts of our state leaders to address this issue so far, Colorado can and should do more to keep kids covered.
The historic loss of health insurance among kids has exposed longstanding issues that create red tape for the families that public insurance programs are intended to serve. We need a system for determining who is eligible for public health insurance that is simple and works harder to keep eligible children enrolled.
Our state’s Medicaid department should:
— Delay eligibility redeterminations for all children, allowing kids to stay covered until the state can ensure they are not being disenrolled for procedural reasons. North Carolina and Kentucky have already taken this step.
— Work more closely with its Regional Accountable Entities, which oversee the coordination of care for Medicaid members in specific regions of the state, and with pharmacies and community-based organizations to give them more flexibility to help enrollees complete the renewal process. These are all flexibilities the federal government has granted states to help stem this crisis.
— Publish disaggregated data on a monthly basis that shows who in the state is losing coverage. This would help us understand which groups and which communities are most affected and target resources accordingly.
At the same time, Colorado must work to successfully implement House Bill 1300, a 2023 law that requires the state’s Medicaid agency to take steps to keep all kids who are enrolled in Medicaid or Child Health Plan Plus covered continuously between birth and age 3 by 2026. This policy would help families with babies and young toddlers avoid the confusing renewal process. We must implement this in a timely fashion, as the unwind has shown on a large scale how the process to renew Medicaid coverage has not been working for kids and families.
We ask state leaders to recognize the gravity of the situation and take immediate additional steps to safeguard coverage for kids and families. Their health depends on it.
Hunter Nelson lives in Denver and is a senior policy analyst at the Colorado Children’s Campaign. She focuses on child and family health policy, including health care coverage, maternal health, reproductive health, food security and gun violence prevention.
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