The 2020 calendar year saw large increases among Health First Colorado (Colorado’s Medicaid program) enrollment in Q2, 3, and 4 and a combination of increases and decreases in Child Health Plan Plus (CHP+). Enrollment in Health First Colorado’s in non-disability programs (i.e. Modified Adjusted Gross Income – MAGI programs) and CHP+ increased by 175,137, or 16.1 percent, in 2020.


In 2020, the total number of adults, pregnant adults, and children enrolled in Health First Colorado MAGI programs increased by 196,544 or 16.3 percent. The total number of children and pregnant adults enrolled in CHP+ decreased by 9,417 or 12.5 percent.

[Additional details and graphs are available in CKF’s 2020 Health First Colorado and CHP+ Enrollment Analysis]

Q1 enrollment trends differed significantly from the remainder of the year, due to the onset of COVID-19. The following are some of the polices and events that impacted enrollment in 2020:

COVID-19 Continuous Eligibility Requirements: States accepting the enhanced federal match through the Families First Coronavirus Response Act are not permitted to terminate Medicaid members who were enrolled on or after March 18, 2020, unless the member voluntarily terminates their benefits, moves out of state, becomes incarcerated, or dies. This requirement continues Health First Colorado coverage for over 300,000 members in 2020 and is in effect until the end of the public health emergency (PHE).[1]

COVID-19 Economic Effects: Colorado’s unemployment rate has risen significantly because of the economic effects of COVID-19, from 2.5% in January to 8.4% in December.[2] While not all people filing for unemployment will be eligible for Health First Colorado or CHP+, this rise in unemployment has likely increased the number of Coloradans eligible for these programs

Challenges in In-Person Application Assistance: Due to social distancing requirement, many organizations that offer application assistance for Health First Colorado and CHP+ did not offer in-person application assistance, or offered limited in-person assistance. Without guidance allowing for remote signatures or verbal attestation, many assistance sites worked to creatively support clients in applying during this time. While sites successfully enacted measures to support clients, this made application assistance less accessible. CKF is thankful that, due to our advocacy and the advocacy of our members, HCPF published a Remote Application Assistance memo in January 2021.

Looking to the Future:

The Biden Administration recently indicated to states that the PHE would likely be extended throughout all of 2021, maintaining the lock-into coverage throughout the year.[3] Due to this and lasting economic impacts from COVID-19, we expect Health First Colorado enrollment to continue to grow, as more Coloradans join and very few disenroll. We will continue to monitor the situation and advocate for policies that enable eligible Health First Colorado and CHP+ members to retain coverage at the end of the PHE – please reach out to Shoshi Preuss with any comments or questions on this post or the changes in enrollment.

[1] Colorado Department of Health Care Policy and Financing, County Human Services Directors and HCPF Executive Director Quarterly Meeting, December 9, 2020

[2] U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics, February 4, 2021

[3] U.S. Department of Health and Human Services, Public Health Emergency Letter to Governors, January 22, 2021,