Turbulence in Coverage Visible at Community Health Centers
Statement attributable to
Colorado Community Health Network (CCHN)
DENVER― In the 2019 Colorado Health Access Survey (CHAS), the Colorado Health Institute (CHI) analysts found that the uninsured rate in Colorado is 6.5 percent, statistically the same as in 2015 and 2017. However, the report points out that this overall stability “masks turbulence just beneath the surface.”
Colorado’s Community Health Centers (CHCs) are seeing this turbulence firsthand; at CHCs, the percentage of people who were uninsured in 2018 was about 23 percent, an increase of two percentage points between 2017 and 2018. The experience of each CHC is different depending on the communities they serve – the percentage of uninsured patients at Colorado CHCs in 2018 varied from 11 percent to 85 percent. Many CHCs are observing a continued upward trend of uninsured in 2019. Across the state, CHCs cared for 40 percent of Colorado’s uninsured in 2018.
Meanwhile, the CHAS notes a 1.2 percent decrease in coverage by Medicaid. At Colorado’s CHCs this decrease is also more pronounced with a two percent decrease.
At CHCs the underlying turbulence is driven by multiple factors including the state’s strong economy. Many people who were previously covered by Medicaid are now making just enough money to no longer be eligible, yet do not make enough to be able to afford private health insurance. The CHAS also shows that more Coloradans switched coverage or went without insurance for part of the year. People may go to a CHC while uninsured, potentially contributing to the increase of uninsured patients at CHCs. The best health care outcomes happen when people are able to build a relationship with their health care providers and maintain continuity of care.
For those patients who can afford private health insurance, many struggle with high out-of-pocket costs, unable to afford co-pays and never reaching their deductibles. This struggle is reflected in the 2019 CHAS results, with nearly one in five Coloradans reporting trouble paying their medical bills in the past year. CHCs serve all patients regardless of ability to pay and are able to offer a sliding fee discount for low-income patients who can’t afford private insurance co-pays. However, these discounts come at a cost to the CHCs, which must seek funding from other sources to offset the costs of providing care to these privately insured patients.
CHC patients are also concerned with the impact of a new public charge rule which changes the way people who are planning to apply for a Green Card access public benefits like Medicaid. CHCs are hearing from families who are scared to stay enrolled, and keep their children enrolled, in Medicaid because of these rule changes.
Other results of the 2019 CHAS mirror what CHCs are seeing statewide: growth in patients accessing medical, dental, and behavioral health.
CHCs continue to work hard to meet the needs of the communities they serve. Between 2014 and 2018, there was a 58 percent increase in the number of CHC facilities offering onsite behavioral health. Over the same period, there was a 38 percent increase in the number of CHC facilities offering onsite oral health services. CHCs are proud to play a part in increasing access to oral health and behavioral health care for the increasing number of Coloradans interested in receiving this care.
The mission of CHCs is not only to provide care to anyone who needs it, regardless of their ability to pay or their insurance coverage or lack of it, but CHCs are also committed to making patients feel welcome.
CCHN is proud of the innovative work that Colorado has done to improve health care coverage and continues to support the work of CHCs to provide access to affordable, high quality care to Coloradans.