Opinion: Medicaid is in crisis, and the safety net insurance is critical to Colorado

For more than two decades, Colorado has invested in the health care safety net because we know that access to health care is a primary path to financial security and quality of life for Coloradans and a healthy, vibrant state for all of us. But over the last year, as we have emerged from the COVID crisis, Colorado has failed our neighbors on Medicaid and jeopardized the safety net health care providers who serve them.

This is a clear failure of leadership at the Colorado Department of Health Care Policy and Financing, the state’s Medicaid agency. Instead of stepping up to help solve this issue, leaders of the agency have been squabbling over numbers and largely deflecting responsibility. The agency must move immediately to tackle this crisis.

We are seeing the impacts every day in the communities we serve. We are outraged and heartbroken about it – and ready to make saving our safety net Colorado’s highest priority in the year ahead.

As has been widely reported, the state has done a terrible job keeping Coloradans enrolled in Medicaid in the wake of the COVID crisis. To recap:

  • Medicaid enrollment in Colorado has dropped by more than 575,000 people – a 33 percent decline of total program size.
  • According to an analysis from the Kaiser Family Foundation, Colorado has the largest net Medicaid enrollment decline in the country.
  • More than half of Coloradans who lost their Medicaid coverage lost it because of administrative failings and bureaucratic barriers – people never receiving their re-enrollment packet, application processing delays and onerous enrollment requirements.

We’re angry about it. And you should be too because whether or not you or someone you love relies on Medicaid, the whole health care system is struggling as a result.

Recently, health care providers – people who run clinics, mental health centers and hospitals – from across Colorado met with legislators to share what the financial implications of the Medicaid disenrollment crisis means for them and their ability to serve their communities. They are reducing hours of operation, laying off staff, closing programs and clinics. Bottom line: it’s getting harder to access care in all parts of the state.

And that is the heartbreaking part – knowing that our neighbors are getting sicker as they struggle to find or delay accessing needed mental and physical health care.

To be fair, the pandemic was hard on care. Costs for supplies, pharmaceuticals and other overhead have increased exponentially. Health care workers burned out and left the field, leading to workforce shortages and increasing labor costs. Medicaid disenrollment is not the only challenge facing providers, but it is a major contributing factor – and it is one we could and should have avoided.

While Colorado has never reached a point where every resident has health insurance, we have done much better in ensuring coverage in recent years. A return to “the bad old days” is unacceptable. In the year ahead, we must make stabilizing our health care safety net and restoring Medicaid coverage for eligible Coloradans our state’s top priority. What does that look like?

First, it means finding ways to invest in our safety net providers. We face an incredible challenge with impending state budget shortfalls, but we must try. At a minimum, we must protect Medicaid providers from reimbursement rate cuts. Beyond that, we should be doing all we can to maximize the Primary Care Fund and draw down every federal dollar available through Medicaid.

Second, it means actively seeking out Medicaid-eligible Coloradans and helping them to enroll. We should be expanding points of entry, reducing administrative barriers and fixing faulty infrastructure that has contributed to the current crisis. Our federal partners should be helpful here too.

Most importantly, a crisis of this magnitude requires leadership and partnership. Rather than responding half-heartedly, our state health care agency and Governor Polis should be leading the charge to solve it. They need to convene stakeholders in a transparent and collaborative manner – health care providers, consumer advocates and county, state and federal leaders – to chart our way forward together. We stand ready, willing and able to support that effort.

Kyle Mullica is an emergency room nurse and a state senator representing Adams County in Senate District 24. Barbara Kirkmeyer is a state senator representing Weld and Larimer counties in Senate District 23 and a member of the Joint Budget Committee.

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