Since Colorado’s Medicaid expansion began in 2013, the state has extended federal health insurance benefits to some 300,000 people. In the meantime, however, it has lagged behind on enrolling eligible residents for food stamps, also known as the Supplemental Nutrition Assistance Program, or SNAP.

The state ranks 45th in the nation for access to food stamps, with only 59 percent of eligible beneficiaries enrolled compared to the national average of 74 percent. That’s leaving roughly $269,000,000 of federal funds on the table every year — money that could help feed needy families and stimulate local economies.

Nowhere is the gap more pronounced than in Colorado’s ski resort country. In Summit County, nearly 80 percent of people eligible for food stamps aren’t enrolled in the program. Eagle and Routt counties have similar gaps, and Pitkin County tops the charts with nearly 89 percent of its eligible beneficiaries unenrolled.

“It’s a huge missed opportunity, especially for smaller, rural communities,” said Joel McClurg, policy director for the advocacy group Hunger Free Colorado.

His organization estimates that Summit’s roughly 3,650 eligible but unenrolled food stamps recipients miss out on $3,240,000 in federal food aid every year, translating to $5,520,000 in lost economic activity.

Enrollment gaps are far higher in some counties than others — only 6.5 percent of qualifying people in Pueblo County are unenrolled — and analysts and government officials are still trying to figure out why.

“The money flows to the state but it’s implemented at the local level, and there’s pretty wide variability in who has access based on where they live,” said Michelle Webster, manager of research and policy analysis at the Colorado Center on Law and Policy. “There’s something happening at the local level where some counties are doing better at enrolling people than others.”

In Summit County and other resort areas, high numbers of seasonal workers likely contribute to low enrollments.

“People who are only in the area for a season may not go to the trouble of applying for SNAP benefits in particular,” said Webster. “The application can be cumbersome, and generally requires an in-person interview. In rural areas that could be a barrier.”

Among eligible Summit residents ages 18 to 24 — a popular demographic for seasonal resort employees — enrollments are only around 10 percent, said Michael Whitaker, the county’s economic security programs supervisor.

“A lot of those people are single, and they don’t have the same needs that families do, and they’re getting by through other means,” said Whitaker.

Another factor, according to a report on SNAP access in ski resort areas by Hunger Free Colorado, are high per capita and median household incomes, which are inversely correlated with food assistance enrollment.

The report speculates that wealth may actually mask food insecurity and lead people to believe they are only poor relative to their affluent neighbors, and thus not qualified for food assistance.

“I think there is a fair amount of stigma,” said Tamara Drangstveit, executive director of the Family and Intercultural Resource Center. “People may feel ashamed they need help, but because of the gap between what it costs to live here and what people earn here, there is no shame.”

That might help explain why SNAP participation has been so much lower than Medicaid enrollments. Whitaker noted that although the percentage of eligible 25- to 34-year-olds enrolled in SNAP is very low, that’s not the case for Medicaid.

According to a sweeping analysis of benefits gaps in Colorado conducted by the Colorado Center on Policy and Law and Hunger Free Colorado, only 40 percent of people who are eligible for Medicaid in Summit aren’t enrolled.

That reflects a strong statewide disparity between Medicaid and SNAP enrollments, one that’s puzzling given that the eligibility overlap between the two is around 60 percent.

“We would’ve expected that as Medicaid caseloads increased, SNAP caseloads would increase, too,” said Webster. “But what we have seen is that SNAP enrollments have actually been lower.”

The Affordable Care Act, also known as Obamacare, provided states with funding to expand their Medicaid programs. Colorado did so enthusiastically, although other federal assistance programs, like SNAP in particular, may have fallen by the wayside.

“With the ACA expansion, there was very high, top-down pressure to enroll as many people as possible,” said McClurg. “SNAP wasn’t the high priority that Medicaid was, but we’re incredibly hopeful that’s starting to change.”

“Historically, getting people access to food assistance has not been a priority in Colorado, and I don’t know why,” said Webster. “Access to stable and healthy food has all of these long-term health benefits. In my view, it’s a no-brainer.”

Medicaid and SNAP are administered by different state agencies. Lately, the two have been working on ways to bridge the gap between food assistance and health coverage that widened during years of frenzied Medicaid enrollments.

“The state leadership is starting to internalize that message, and from there it needs to trickle down to counties,” said McClurg. “What’s needed is a clearer mandate from the state.”

In Summit County, Whitaker said, the Human Services department has been working to partner with groups like FIRC and the Summit County Care Clinic to encourage cross-enrollments, where people can apply for Medicaid and SNAP at the same time if they qualify for both.

“We would encourage anyone and everyone to come in or reach out to our community partners,” he said. “We’re here, we’re available, and we’ll sit down with anyone to see if they’re eligible.”