The number of La Plata County residents enrolled in Colorado’s Medicaid program shrank by 40% during the 14-month period in which Health First Colorado customers had, for the first time in three years, to prove their eligibility for state-subsidized health care.
“We hear from a lot of people who are very upset about having lost their Medicaid, who don’t understand why they did,” said the county’s Human Services Director Martha Johnson.
Under a federally mandated continuous coverage requirement, nobody was booted from the Medicaid roles between start of the COVID-19 public health emergency in March 2020, and the end of the emergency declaration in May 2023.
Medicaid enrollment in La Plata County grew 46% between March 2020 and December 2022, in line with statewide trends. The state had estimated that 19% of Medicaid customers would be deemed ineligible, although that number proved to be much higher in La Plata County.
In Montezuma County, the drop was far less significant – about 8,800 had Medicaid in April 2023, compared with 7,800 in May 2024 – or an 11.4% decrease.
In March 2023, Medicaid customers began receiving notices requesting that they provide proof of their eligibility. In Colorado, an individual who makes no more than $1,669 gross monthly income is eligible for Health First Colorado coverage; children in households that make no more than $3,263 gross monthly income are eligible for Child Health Plan Plus (CHP+).
The 40% drop in enrollment in La Plata County reflects everyone who was kicked off Medicaid in addition to anyone who signed up.
Emma Tomlinson, who runs the health insurance literacy program at La Plata County Public Health, said she saw an influx of clients during the unwind who lost coverage for various reasons.
Some people had moved and never received the request to submit eligibility paperwork; others did not realize how important the request was.
“They’re old rules that weren’t applied during the pandemic (and) came back, and customers just really weren’t used to it yet,” she said.
According to statewide statistics available from the Colorado Department of Health Care Policy and Financing, 19% of people on the rolls during the unwind were unenrolled because they were ineligible financially; another 25% of people were unenrolled for procedural reasons.
In the months since the unwind ended, procedural denials have dipped to pre-pandemic rates around 11%.
“Typically, it’s going to the doctor (or) going to the pharmacy to pick up prescriptions, and they are told right then and there that they don’t have it (Medicaid) anymore,” Tomlinson said. “It’s a pretty rude awakening.”
Maria Warren, a Durango resident who works as a caregiver, received a notice to reapply sometime in the middle of 2024. She submitted the required proof of income and was told she made too much to qualify.
In September, not long after she lost Medicaid coverage, Warren was hospitalized for a bite from a black widow spider that exacerbated some existing health issues. She had no insurance at the time because, ironically, she had to stop seeing the therapist who helped her with the executive functioning needed to secure new coverage.
“All of a sudden something happens and it could easily snowball,” she said. “I was seeing how that could get really out of hand.”
The state’s open enrollment period, when Coloradans can sign up for health care through the Connect For Health Colorado marketplace, began Nov. 1. Marc Williams, a spokesman for HCPF, said in an email many people may requalify.
“We expect a number – no estimate – will learn that they still qualify for Medicaid and will be reenrolled,” he wrote. “That will be something to keep an eye on in the coming months.”
The rigid nature of Medicaid eligibility, which is determined by recent paychecks, is difficult for seasonal workers like Mancos resident Jess Bisner, who works on a farm and as a backpacking guide.
“These contracts that I do are just an on-off,” she said. “So maybe make $2,000 this month, but then I only make $500 or $800 next month.”
But a few recent months of lucrative work were enough to get her kicked off Medicaid in August. She hoped to be eligible again this month.
“It’s just a stressful process to be getting kicked off and on and not knowing when you’ll have to secure health care,” Bisner said.
Resources for those with questions about health insurance are available from the state at bit.ly/4fdMRxH or from the county’s health insurance literacy program.
The open enrollment period lasts through Jan. 15.
rschafir@durangoherald.com
