In October, the Colorado Health Institute released the 2021 Colorado Health Access Survey (CHAS), Navigating Uncharted Waters: The Pandemic, Health Coverage, and Care in Colorado. The CHAS is a survey that the Colorado Health Institute conducts every other year to document different factors that impact Coloradans’ health outcomes. These factors include access to care, social and economic factors, and overall health status. This blog will describe some of Colorado Health Institute’s health coverage findings related to uninsurance rates and public benefit programs, specifically Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+). The complete survey and regional profiles are available from the Colorado Health Institute.
The 2021 CHAS report’s findings on health coverage highlight the impact of the continuous eligibility provision, also known as the coverage lock-in that is in place during the COVID-19 Public Health Emergency (PHE). This provision prevented Coloradans from losing their Health First Colorado or CHP+ benefits since March 2020. During the PHE, members could only be disenrolled from coverage if they moved out of state, became incarcerated, voluntarily disenrolled from benefits, or died. The other exceptions include CHP+ pregnant members, after the 60-day postpartum period, and children enrolled in CHP+ who turn 19 and age-out of coverage.
Increase in Coloradans enrolled in Health First Colorado and CHP+
Around 25% of Coloradans were enrolled in Health First Colorado and CHP+ in 2021, increasing from 18.7% in 2019. In comparison, during this time, Coloradans enrolled in insurance from their employer decreased from 52.7% in 2019 to 49.8% in 2021.
Decrease in Churn
The CHAS found a decrease in churn, defined as the process of losing, switching, or gaining coverage. Overall churn for all types of health coverage, including public programs and private plans, decreased from 17.3% in 2019 to 13.3% in 2021. Of the 13.3% of Coloradans who experienced churn, the majority (55.1%) lost employer insurance. An additional 21.1% found a better plan, while only 7.5% churned off of Health First Colorado and CHP+. In comparison, in 2019, 16% of Coloradans who experienced churn churned off Health First Colorado and CHP+. The overall decrease is likely due to being locked-in to coverage and supports for people to continue their employer sponsored insurance, such as the additional COBRA subsidies. Of the Coloradans who churned off Health First Colorado and CHP+, it was likely due to the exceptions to the lock-in to coverage, as noted above, and members who gained employer coverage. However, this is an area that CKF is still exploring.
Sustained Low Uninsurance Rate
Colorado’s uninsurance rate remained steady at 6.6% of the population, or 380,000 people. The uninsurance rate varied widely by region from 3% in Douglas County to 13.2% in the Upper Arkansas Valley, which includes Lake, Chaffee, Fremont, and Custer counties. Of those who were uninsured in 2021, which is down from 29.1% in 2019. This means that roughly 45,000 Coloradans became uninsured from losing their Health First Colorado or CHP+ coverage. Of those, it was likely due to the exceptions to the lock-in to coverage. However, along with churn, this is also an area that CKF is still exploring.
The CHAS provided additional insight into the demographics of uninsured Coloradans and reasons for being uninsured. The CHAS found that Coloradans ages 30-49 and 19-29, and Hispanic/Latino Coloradans were most likely to be uninsured. In addition, due to job loss from the pandemic, there was an increase in the number of Coloradans who became uninsured because someone in their family lost or changed their job (42.7% in 2021, 34.6% in 2019).
CKF is excited about these findings as it demonstrates how federal and state intervention enabled Coloradans to maintain health coverage during this crucial time. CKF will continue to engage with HCPF on the COVID-19 unwind to ensure that eligible members maintain coverage.
This blog only described one section of the 2021 CHAS. We recommend reading the report for more information about health coverage trends and key findings about social and economic factors impacting Coloradans.