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Partner to Keep Coloradans Covered
Please register to join Health Care Policy & Financing (HCPF) leaders for a webinar Aug. 8, from 9 to 11 a.m. This event will share what we accomplished together last fiscal year, address our priorities for this fiscal year, and invite stakeholder feedback and comments. Join us Aug. 8 for HCPF’s annual meeting.
Of all the important work we have in progress, HCPF’s #1 priority has been working with our stakeholders - care providers, advocates, counties, and more - to achieve our shared goal to Keep Coloradans Covered, now that the end of the public health emergency (PHE) is upon us. As federally required for all states, we are now acting on Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) program renewals for the first time since March of 2020. Thank you for helping us renew those who continue to qualify for our safety net health coverage programs and connect those who no longer qualify for our programs to affordable, alternative coverage.
Emerging renewal data can help us determine where we need to focus and refine our strategies to achieve our shared goals. It is too early for any trends, but we are closely reviewing the data we have now. To better understand the PHE unwind data, we looked at history. As you may know, members often lose eligibility for Health First Colorado or CHP+ during the renewal process because they no longer qualify. Commonly, individuals will enroll and be disenrolled from Health First Colorado or CHP+ due to changes in their life circumstances, like losing or gaining a job or changes in their household composition.
As we return to regular renewal processes, we certainly expected that more individuals would no longer qualify for our safety net coverage programs because Colorado’s economy is so strong. That’s important, because the vast majority of those newly enrolled in Health First Colorado over the last three years did so during the COVID-induced economic downturn. As of May 2023, Colorado’s unemployment rate was lower than pre-pandemic levels, at 2.8% - we are one of the strongest economies in the nation - with an increasingly positive outlook. We will be actively monitoring the economy this fiscal year based on its direct impact on our coverage numbers.
Colorado’s data on those up for renewal in May, pulled June 26, offers a snapshot of the first month of the required return to regular Medicaid eligibility operations. The point in time data shows very similar renewal metrics compared to the two years prior to the pandemic, with 56% of those with May renewal anniversaries being renewed for Health First Colorado or CHP+ coverage (compared to 57% pre-pandemic). Of the 56% renewed in May, 43% were automatically renewed through advances in our processing technology (“ex parte”) made over the last few years, while 57% were renewed after completing the renewal packet. 42% of individuals initially no longer qualified for public safety-net coverage, which also closely aligns with the 41% pre-pandemic average. We say “initially” because we expect that percent to change as late applications are received or individuals receiving termination notices choose to send in their renewal information within the 90-day reconsideration period. Of the 42% disenrolled, 16% no longer qualify due to exceeding income criteria and 26% lost eligibility for procedural reasons such as not completing the renewal paperwork submission process (compared to 12% prior to the pandemic). Of the 26% who were denied due to procedural reasons, 36% could not be located.
We’re prioritizing finding ways to reach people who are procedurally denied, including those we can’t find. Our Centralized Return Mail Center has updated addresses for nearly 70% of cases for which we have received a piece of returned mail so that we can successfully reach them when it’s time to send renewal packets. We are outreaching the remaining 30% who are locked into coverage that we couldn’t find the month before their renewal anniversary to help prevent them from being procedurally denied due to whereabouts unknown. We appreciate your partnership in spreading the word to members that it’s critical they update their contact information.
Our success in our united effort to Keep Coloradans Covered - including your active and engaged partnership - will mitigate the consequences of individuals going without coverage - impacting families, providers, employers and our economy. Data on those up for renewal in June, pulled in early July, reinforce the same areas of focus: 48% renewed (we expect this number to go up as pending applications and late applications are processed throughout the 90-day reconsideration period), 49% no longer qualified and 34% lost eligibility for procedural reasons such as not completing the renewal paperwork submission process; of that 34%, 36% could not be located. These data are points in time and will continue to change, especially as our reporting evolves to provide updated data on historic months and better reflect those that come right back onto coverage and those that voluntarily disenroll because they have other coverage. Please visit our Continuous Coverage Unwind Data Reporting webpage for data, further details and FAQs.
Since each state is approaching the renewal implementation process differently, comparisons across states are not as relevant as looking at prior trends for renewals within that state. That said, on July 28, CMS released information on 18 states which started processing renewals for April. Note that Colorado is not one of these states since we returned to regular renewal processing in May. Accordingly, CMS will release our May data in late August. CMS’s national data from April showed an average of 22% of applications still pending determinations, which further complicates comparisons given Colorado’s far lower 1-3% pending applications. All that said, the national average for those 18 states for April renewals is: 45.5% renewed, 32.2% no longer qualified for eligibility reasons, and 25.6% no longer qualified for procedural reasons.
We are also analyzing data by race/ethnicity, age and region to help identify and mitigate any emerging inequities. Based on the limited information available so far, we have not yet observed any race related disparities in the tracked renewal metrics between white people and people of color, which is good news. That said, it is important to mitigate disparities overall for low income people of color through this important work, and we are indeed focused on achieving that important shared goal.
To avoid health coverage gaps and disparities that historically impact communities of color, LGBTQ+, rural, non-English speakers and people with disabilities, we all need to work together to Keep Coloradans Covered - a key health equity priority. Providers, educators, community leaders and advocates - you are our trusted messengers on the ground, seeing our members when they walk through your doors. We ask that you meet them where they are, post flyers, send notifications, make phone calls, talk to them when they’re in front of you, and remind them to open the renewal mail and complete and send in the packet by the renewal deadline.
HCPF is indeed working diligently, quickly and comprehensively to identify gaps and more importantly, to address emerging issues. We have met with other states to share findings and we are holding a series of stakeholder meetings to identify member communication strategies that are working as well as those proven less effective. These learnings will inform our future collaborative outreach efforts.
Please consider these requests as you also refine your outreach and communication strategies to Keep Coloradans Covered:
- It is common for individuals to miss their renewal date submission. Individuals should use their existing renewal application instead of starting a new one if they are within the 90-day window of their renewal anniversary. If they do not take action within those 90 days, they must reapply (fill out and submit a new application along with verifications) to regain coverage if they are eligible.
- The renewal process may take longer for individuals with disabilities who access HCBS waiver supports. Please encourage this population and their support community to take action early and seek help with their renewals if they need it. HCPF is actively working with advocates, Regional Accountable Entities, case management agencies and counties to implement initiatives that focus on this population.
- Please remind parents that their children may still qualify for Health First Colorado or CHP+ coverage even if the parents no longer do.
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If individuals no longer need Health First Colorado or CHP+ coverage - usually because they secured a job with employer-sponsored coverage - they can voluntarily disenroll at CO.gov/PEAK or by contacting their county Human Services Department. We are working on making that process easier. Knowing who no longer needs our coverage will help us focus on reaching people who do.
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Only 3% of Coloradans voluntarily disenrolled from Health First Colorado and CHP+ coverage, despite the massive reduction in Colorado’s unemployment rate from its COVID-induced high. We expect many of these people are eligible or currently have employer-sponsored coverage. We’re working with Chambers of Commerce and other employer-organizations across the state to promote employer-sponsored coverage for people who disenroll from Medicaid including raising awareness with their employees on how to enroll in their employer-sponsored coverage.
Thank you for leveraging these tools to help members take action to renew their coverage and update their contact information so we can reach them with important renewal information. Partners and providers, please keep educating staff and patients about the return-to-regular renewal process. Resources are available to help you:
We truly appreciate your partnership to Keep Coloradans Covered as well.
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