CHI releases Colorado Health Access Survey showing the success of the safety net and health disparities


Patrick Jones


The Colorado Health Institute (CHI) released their 2021 Colorado Health Access Survey (CHAS) earlier this week, with updates as late as Oct. 27. Though many Coloradans lost their job-based insurance, had their incomes reduced, and suffered from mental health issues, the survey shows that the safety net worked to catch many Coloradans. 


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The CHAS surveys more than 10,000 Colorado households every other year since 2009 and attempts to measure information on how residents access care, their health coverage, and factors that influence health outcomes. For the 2021 survey, results were fielded from Feb. 2021 to June 2021. CHAS says this acts as a resource for policymakers, health systems, and providers to inform them on the issues facing Colorado’s health system. 

Insurance coverage and Medicaid enrollment

The survey shows a decrease in employer-sponsored insurance coupled with a rise in Medicaid enrollees during the pandemic. 


Image: Colorado Health Institute


The survey shows that the Medicaid system was able to step in to fill the gap of those who lost their health insurance through job loss. As a result, the uninsured rate in the state remained at 6.6%, which has been relatively unchanged since 2015. 

Jeff Bontrager, director of research and evaluation at CHI, highlights his concerns on how this might affect Coloradans at the end of the public health emergency provisions to keep people on Medicaid without regular redetermination procedures. Other nearby states — like Utah and Washington — are having similar concerns. 

“This is important because there’s a lot of energy right now being devoted at our state agencies … to understanding what the potential implications are once the public health emergency comes to an end … It’s a question whether [the public health emergency] will be prolonged again or whether people who are enrolled in Medicaid, who’s eligibility has changed, what sort of transition they will have to other coverage and benefits.”

Disparities in health care and social determinants of health

During the pandemic, 38.3% of Coloradans had a decline in mental health wellbeing. Other factors contributing to declines in mental health include reduced work hours or income (29.3%), job loss (11.9%), and a struggle to pay for basic necessities (17.2%). 

Among these factors, American Indian/Alaska Native and Black/African American populations were hit significantly harder than White populations. 


Image: Colorado Health Institute


Eric Moore, director of advocacy at The Center for African American Health in Denver, says:

“People were impacted by losing a job, reducing hours, having to take on an extra job or hours — and a lot of people were in a position where paid family leave wasn’t an option when they were dealing with illness or the loss of loved ones. Our community was particularly affected by COVID, mainly because of lack of access to health care and being exposed in industries as essential workers.”

These disparities lead directly to worse mental health statewide. Coloradans reporting poor mental and behavioral health grew to its highest level since the survey started collecting data in 2009. Nearly one in four Coloradans reported eight or more poor mental health days in the past month. 


Image: Colorado Health Institute


Housing instability and food insecurity proved to be major reasons for poor mental and behavioral health in the state.


Image: Colorado Health Institute


CHAS also includes survey results for the use of health care in 2021 and the general health of the population. See the video presentation of the survey here.