Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Medicaid Coverage Trends topic
No spam. Unsubscribe anytime.
Colorado Health Institute presentation: CHAS data shows Medicaid expansion reduced uninsurance; potential federal cuts and tax-credit expirations could reverse
Summary
The Colorado Health Institute told the House Health and Human Services Committee that Colorado—s Medicaid expansions and Affordable Care Act market changes drove major reductions in the state—s uninsured rate but warned that proposed federal Medicaid cuts and the scheduled expiration of expanded marketplace tax credits could raise uninsured rates and out-of-pocket costs for many Coloradans.
The Colorado Health Institute told the House Health and Human Services Committee that Colorado—s Medicaid expansions and Affordable Care Act coverage changes substantially reduced the state—s uninsured rate, and that proposed federal Medicaid funding cuts and the likely 2026 expiration of enhanced marketplace tax credits could sharply raise the number of Coloradans without coverage.
The CHI presentation to the committee emphasized long-term trend data from the Colorado Health Access Survey (CHAS), which CHI said surveys more than 10,000 households every two years and provides geographically representative estimates. "Colorado's Medicaid expansions ... have been really instrumental in getting health insurance to people who didn't have it before," CHI communications director Joe Hanel told the committee, and CHI director Suman Mathur described CHAS as the state's "premier source of data on coverage, access, uninsurance, social factors, and more."
CHAS data shown to the committee traced Colorado—s uninsured rate from roughly 13–16% in 2009 to a sharp fall after 2013—2015 (the period that included the ACA market changes and Colorado—s 2014 Medicaid expansion). CHI said the uninsured rate fell to about 6.5% from 2014 to 2021, briefly reached a record low of 4.6% in 2021 during the COVID public-health emergency, and that 2023 CHAS data were collected during the PHE unwind. Hanel said CHI—s 2025 survey is currently in the field and will shed more light on post-unwind changes.
Why it matters: CHI highlighted two near-term federal risks to Colorado coverage. First, congressional proposals under discussion could cut hundreds of billions from Medicaid nationally; CHI cited media and national models that project statewide Medicaid enrollment drops and state budget pressure if federal support is reduced or converted to per-capita caps. "If that were to fall all on Medicaid, that would be more than 10% of federal Medicaid funding," Hanel said; he also directed members to the state Department of Health Care Policy and Financing (HCPF) for administrative dollar estimates. Second, federal marketplace subsidies expanded by the Inflation Reduction Act are set to expire at the end of the year unless Congress extends them. CHI and outside modelers (Kaiser Family Foundation) showed how expiration could double or triple out-of-pocket costs for typical buyers on the individual market in many parts of the state, driving some to drop coverage.
CHI used CHAS microdata to describe who would be affected. According to CHAS 2023 estimates presented, adults without children are a large share of expansion enrollees; about a third of Colorado Medicaid enrollees were children, roughly half were white, 34% were Hispanic/Latino, and CHI showed employment status among those 16+: roughly 50% employed, 14% looking for work, 36% not in the labor force. CHI stressed that many Medicaid enrollees are working and that losing eligibility because of policy change (not income gains) would likely produce uninsured Coloradans.
Speakers and exchanges: Committee members asked CHI staff to explain who qualified under expansion and why working adults appear in Medicaid counts. Hanel and Mathur said the ACA expansion covered adults up to roughly 138% of FPL and that CHAS captures a broad range of working and nonworking enrollees, including students and caregivers. CHI representatives repeatedly cautioned their projections are model-based and encouraged members to consult HCPF for precise fiscal figures.
What CHI did not assert: CHI presented survey-based estimates and national modeling results but did not assert a state fiscal estimate for any specific congressional proposal. It did not propose legislation; instead the presentation focused on likely coverage and access consequences of federal changes.
Ending: Committee members asked for follow-up data; CHI staff said they will take suggested supplemental questions for future CHAS rounds and to HCPF for financial estimates. The CHAS 2025 fielding was under way at the time of the presentation.
