Colorado’s Democratic U.S. senators and representatives asked the federal agency regulating Medicaid on Tuesday to reconsider a decision that won’t let the state keep toddlers and former prisoners covered.
In November, under the Biden administration, Colorado received approval from the federal Centers for Medicare and Medicaid Services to cover children up to age 3 without requiring their parents to go through the process of repeatedly proving they qualify. Previously, children who qualified at birth were automatically covered by Medicaid for 12 months, which will continue.
The change also would allow the state’s Medicaid program to cover adults leaving prison during their first year back in the community. Both provisions are scheduled to take effect in January, under a law the legislature passed in 2023.
But in July, CMS announced it would no longer approve new changes of that type, or extend existing ones. Dr. Mehmet Oz, the agency’s administrator in the Trump administration, said allowing people to remain enrolled when they would have become ineligible would increase costs and direct resources away from “the truly vulnerable.”
The Colorado Department of Health Care Policy and Financing, which runs Medicaid in the state, said the changes would allow people to remain eligible despite fluctuations in income.
Young children need insurance coverage to keep up with their check-ups and developmental screenings, it said, and people leaving prison are at high risk of hospitalizations and overdoses.
Given CMS’ decision, however, the department is no longer working to implement the changes, spokesman Marc Williams said. Officials are still working out how to follow all aspects of the law, given that the legislature ordered it to do something that the federal agency will no longer allow, he said.
Sen. Michael Bennet, Sen. John Hickenlooper, Rep. Diana DeGette, Rep. Brittany Pettersen, Rep. Jason Crow and Rep. Joe Neguse urged CMS to reconsider in a letter Tuesday. They said the state’s data showed that children who received continuous coverage were more likely to use primary care and less likely to end up in a hospital.
“Children with coverage are more likely to get care early rather than to allow a simple ailment to turn into a more complex — and more expensive — one,” they wrote in the letter.
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