Expanded Medicaid program offers insurance for lower-income High Country residents
December 17, 2013
Colorado has expanded Medicaid, a federally and state-funded health care program for lower-income families and individuals, to cover more residents, effective Jan. 1, 2014. The Affordable Care Act calls for a Medicaid expansion to cover nearly all adults with incomes at or below 138 percent of the Federal Poverty Level (FPL): $15,856 for an individual, $32,499 for a family of four.
“This is the first time ever they’re accepting adults without children, or who aren’t disabled,” said Sarah Vaine, CEO of the Summit Community Care Clinic. “It could be adults who maybe can’t work full time, but also younger people just starting out and trying to survive up here.”
The federal government pays 100 percent of the cost of coverage from 2014 to 2016, eventually scaling down to 90 percent in 2020; a Supreme Court decision in June of last year makes the Medicaid expansion a state option.
Between Oct. 1 and Dec. 14, there were 137,201 Coloradans signed up or approved for health coverage that begins Jan. 1, 2014, according to data released Dec. 16 from Connect for Health Colorado and the Colorado Department of Health Care Policy and Financing. Of those enrollments, 114,192 were for Medicaid — more than 80 percent.
From Dec. 1 to 14 alone, there were 49,902 people enrolled in Medicaid expansion in the state. In that time period, almost 30 percent of the Coloradans who were found eligible were between 18 and 25 years old.
“It is a very busy time at Connect for Health Colorado as we support thousands of Coloradans who are signing up for health insurance that will begin Jan. 1, 2014,” said Patty Fontneau, CEO of Connect for Health Colorado in a prepared statement. “We are focused on encouraging Coloradans to sign up now for health insurance and providing a range of ways for customers to get the help they need to complete the process.”
In Colorado, the income limit for an individual adult has been raised past the FPL to 133 percent. Vaine is concerned many individuals living and working in the High Country don’t know they might now be eligible for the insurance.
“It’s a huge bonus for people, but they either feel a stigma associated with it, or think there’s a cost, or it’s only for moms and kids,” she said.
The latest sign-up date for Jan. 1 coverage is Dec. 23, 2013. Applications for Medicaid include information such as age, family size and income.
“People get nervous about the process and I don’t blame them for that,” Vaine said. “It can be intimidating, with all of the information you have to give, but it’s such a great benefit.”
Coloradans seeking an advance premium tax credit for health insurance must first be determined not eligible for Medicaid. Errors on applications or problems verifying information can delay application processing.
“If someone is just over the income for Medicaid, that’s always hard,” Vaine said. “They have to pay for something and they’re living close to the margins financially. But those people are getting the best deals, their tax breaks would be highest.”
Coloradans can also buy health insurance until Dec. 23 without applying for financial assistance and receive the tax credit, if eligible, when filing taxes in 2015. Those who applied by that date, but didn’t receive Medicaid determination, can also purchase health insurance and pay the first month’s premium and then get the tax credit applied to the rest of 2014 payments.
“The biggest concern is that many more people are eligible in our community now, it’s free to them, it can be exceptional coverage if someone has gone without insurance for a long time, and people just don’t know they can apply,” Vaine said.
An individual adult in Colorado who makes $1,273 per month would be eligible for Medicaid, according to the Center for Medicaid & CHIP services.
From Oct. 1 to Dec. 14, a total of 104,959 people enrolled, and 9,233 Adults without Dependent Children were wait-listed. In 2012, new programs were added to Medicaid, including the Medicaid Buy-In Programs for People with Disabilities and Adults without Dependent Children.
Colorado Medicaid does not have the enhanced federal matching funds to start coverage for the newly eligible population prior to Jan. 1, 2014. Colorado has a wait list for the Adults without Dependent Children program. Individuals on the wait list must make less than 10 percent of the poverty line, or less than $95 per month, and will be automatically enrolled under the expansion with coverage Jan. 1, 2014.
While Colorado as a whole is seeing a large percentage of enrollments under the expanded Medicaid program, Vaine said in Summit County — where many more people might now be eligible — she has not noticed a drastic increase in applications.
“It’s such a great program, and people aren’t signing up in a way we had hoped they would,” she said. “We thought people would flood into social services to sign up, and it’s been more of a trickle. We are waving the Medicaid flag — we want everyone to sign up who can.”
To determine eligibility or enroll in Medicaid, visit http://coloradopeak.force.com or call 668-9716 in Summit County.