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Coalition warns Colorado safety net strained as Medicaid unwind leaves hundreds of thousands uninsured
Summary
A coalition of safety-net providers told the House Health & Human Services Committee that Colorado faces large coverage losses and operational strain after the Medicaid continuous coverage unwind, with federal grant payment interruptions and calls for investments in enrollment systems and the primary care fund.
A coalition of Colorado safety-net providers told the House Health & Human Services Committee on a presentation day that the state's health safety net is under acute strain after the end of continuous Medicaid coverage and recent federal grant interruptions.
The Save Our Safety Net Coalition, represented by Ross Brooks, CEO of Colorado Community Health Network, and policy and economic experts from the Colorado Center on Law and Policy and the Colorado Future Center, pressed lawmakers to invest in enrollment systems, preserve Medicaid funding and expand the Primary Care Fund.
The coalition said the scale of coverage loss is large. "An estimated 575,000 people lost Medicaid coverage during the unwind," Bethany Pray, chief legal and policy officer at the Colorado Center on Law and Policy, said in the presentation materials and remarks to the committee. The group told lawmakers that an analysis suggests 65% of those disenrollments were driven by administrative barriers such as county backlogs and IT and enrollment system fragmentation, not purely by eligibility changes.
Why this matters: presenters said these coverage losses ripple across hospitals, community health centers and mental health providers and remove federal dollars that sustain care and local economic activity. Phyllis Resnick, executive director and lead economist at the Colorado Future Center, said the healthcare sector is a major economic engine for the state and that losing federal Medicaid dollars contracts economic activity.
Details and examples
- Community health centers reported a jump in uninsured patients: presenters cited 23% of community health center patients uninsured in 2023 and a mid‑2024 survey showing a 21.7% growth in uninsured patients through August 2024. Hospitals reported more than a 50% increase in emergency department patients without insurance, the coalition said.
- Operational and cash‑flow effects: Ross Brooks warned that a federal payment systems suspension for federal grantees left community health centers temporarily unable to draw federal grant funds to meet payroll. "If that goes for a month, for 4 weeks, that'll be $9,000,000 in federal funds that we cannot draw," Brooks said, adding that continued interruptions could force furloughs or clinic closures.
- Funding and policy asks: the coalition asked the legislature to stabilize Medicaid funding, invest in the Primary Care Fund to expand access to medical, dental and behavioral care for uninsured people, invest in Medicaid enrollment systems and expand points of entry for enrollment (for example, through hospitals and other community sites that can assist with applications).
Committee discussion and next steps
Committee members asked how points of enrollment could expand and what barriers existed. Pray and other presenters said expanding enrollment assistance requires training, oversight and coordination with the Department of Human Services and county partners. Brooks and Pray emphasized maximizing federal draws and transparency on who is eligible but not enrolled ("EBNE").
The coalition concluded by offering to work with the legislature to identify investments that could reduce administrative disenrollments and restore federal funding flows.
Ending
Presenters asked legislators to prioritize coverage stability and the Primary Care Fund as the committee and the broader legislature weigh budget decisions that will affect vulnerable Coloradans' access to care.
