High costs for health services and insurance are preventing many Coloradans from getting the care they need.
The Colorado Health Institute (CHI) released results from the 2023 Colorado Health Access Survey (CHAS), which gathered resident data connected to health coverage, access to care, and other factors that influence health. Colorado Health Foundation (survey sponsor) Senior Program Officer Liz Charles noted the importance of the annual report.
“The time is so crucial right now for us to build a collective power to address a public health emergency (PHE), Medicaid disenrollment, (and an) influx of migrants and refugees that need specific, unique, targeted, (and) intentional care and services,” Charles said. “And what better way to understand those needs and the complexities of the areas we work in than with this data?”
CHI President and CEO Sara Schmitt hosted a presentation to discuss CHAS results on Thursday. She discussed Colorado’s uninsured rate, which was 13.5 percent when the first survey was released in 2009. The rate was 6.6 percent in 2021, and it dropped to 4.6 percent in 2023.
“That is the lowest uninsured rate we have had since we started the CHAS,” Schmitt said. “However, beginning in May 2023, Colorado joined the rest of the country in redetermining Medicaid eligibility following the end of the public health emergency.”
Medicaid and Children’s Health Insurance Program enrollment declined by 368,108 from March 2023 to December 2023, according to KFF.
“We really don’t know, through this process, how many Coloradans will perhaps have gained coverage through a different source or may become uninsured. The CHAS is not reflecting those activities right now. We believe we will need future CHAS data in 2025 to help us understand what has happened as a result of the redetermination process.”
— Schmitt
The CHAS included statistics for the uninsured rate among different races. Hispanics had the highest uninsured rate at 8.9 percent in 2023, which was down from 14.4 percent in 2021. The rate for white residents was 3.3 percent in 2023—down from 4 percent in 2021—while the rate for Black residents was 2 percent in 2023, a decrease from 4.6 percent in 2021.
The main reason for lack of coverage for participants was that the cost for insurance is too high, with nearly 87 percent of them citing that as the top cause. The second most common reason was that someone in the family who had health insurance lost their job or changed employers (nearly 26 percent).
Lindsey Whittington, data and analysis manager at CHI, noted that the CHAS also found that more than a million Coloradans couldn’t afford the healthcare they needed. The CHAS took a composite measure of people who could not afford general doctor care, specialist care, or needed prescriptions. And 19.8 percent of participants said they couldn’t afford those things. That rate has not been below 18.5 percent (with a high rate of 21.6 percent in 2011) since 2009.
“Those who are not covered are most at risk, as over half of the uninsured reported that they didn’t get the healthcare they needed in the last year because of fear of cost. But just because you have coverage doesn’t make you immune to this issue, as about one-fourth of those who have coverage through the individual marketplace said they didn’t get care because of those costs.
It’s no wonder that so many people are having to make really hard decisions about getting healthcare services because of this overwhelming need to also afford housing (and) food. There’s a lot of conflicting affordability issues that are impacting a lot of Coloradans.”
— Whittington
This was the first year CHI included questions related to climate and health on the CHAS, Schmitt said.
“And our takeaway is that Coloradans are experiencing negative health effects due to our changing climate,” Schmitt said. “But they’re not totally confident their communities are prepared to deal with these challenges.”
Nearly two million Coloradans said climate change impacted either their health or their family’s health. The top health issue related to climate change was related to respiratory illness or problems breathing, which was cited by nearly two-thirds of CHAS participants.
“We also had about one-third [of participants] who cited mental health or substance use impacts as a result of a change in climate.”
— Schmitt
About 47 percent of CHAS participants said their local community was not prepared to respond or recover from a climate-related disaster, while the same percentage said their community was moderately, well, or very well prepared for one.
The rate of Coloradans reporting eight or more poor mental health days in the past month was 26.2 percent in 2023, up from 23.7 percent in 2021. The rate was 15.3 percent in 2019.
The percentage of Coloradans reporting they did not get needed mental healthcare in the past 12 months was 17 percent in 2023, up from 14.1 percent in 2021.
“We can really see, especially in the last couple of years, this increased need and demand for mental healthcare services,” Whittington said. “Especially after the beginning of the COVID-19 pandemic, where we saw a significant increase between 2019 and 2021 data.”
The CHAS also asked participants to report whether they were worried about having stable housing or not. More renters (16.9 percent) were worried, compared to only 2.4 percent of homeowners who worried about it.
“When we think about the housing issue in Colorado, it is overwhelmingly a renter’s issue,” Whittington said.
I am curious if you know, since the insured population is statistically up but the number of people that still do not present to the doctor when ill or hurt because they can’t afford the care, is the cost of care real or perceived and is this a result of High 1st dollar deductibles that the co Sumer is subject to.