By Mike McKibbin / NewsBreak Denver / Aug. 10, 2023
[DOUGLAS COUNTY, COLO.] — While monthly numbers varied widely so far this year, Douglas County had 1,000 fewer residents covered by Medicaid in July than in January.
Federal and state officials had warned of a sharp enrollment decline in the federal government-sponsored health insurance program after declaring the COVID-19 pandemic public health emergency over in May. Those who had Medicaid when the pandemic was declared in 2020 continued to be covered until the emergency ended. Now, enrollees continued eligibility is redetermined monthly.
Through the first seven months of the year, the state Department of Health Care Policy & Financing reported Douglas County had the following numbers of Medicaid recipients:
• 41,236 in January;
• 41,637 in February, 401 more than January;
• 42,030 in March, 393 more than February and 794 more than January;
• 41,797 in April, down 233 from March but still up 561 from January;
• 42,094 in May, up 297 from April and 858 more than January;
• 41,271 in June, 823 more than May and 35 less than January; and
• 40,174 in July, 1,097 fewer than June and 1,062 less than January.
Erin Johnson, Medicaid, food, and cash assistance programs manager for the county health department, wrote in a July email that the county does not have county-specific data on the numbers or reasons for the monthly changes.
“Over the course of the pandemic through May 2023, while Medicaid recipients have been ‘locked-in’ to coverage statewide, there have been three reasons someone could be removed from Medicaid: individual request for closure, a move out of state or death of the recipient,” she wrote. “Additionally, if individuals move from county to county in Colorado, their Medicaid case is transferred to their county of residence.”
Johnson also noted that beginning in June, some people were removed because they no longer qualified due to becoming employed and their income exceeds Medicaid limits. Other reasons include not meeting other eligibility criteria or procedural reasons, such as not returning paperwork.
Johnson added those who no longer qualify because their income is too high should reach out to the state’s private health insurance exchange, Connect for Health Colorado, to see if they might qualify for lower-cost health insurance.
In a May email, Johnson stated state officials complete around 4,000 Douglas County Medicaid renewals monthly.
“We do anticipate the numbers of individuals receiving Medicaid to continue to fluctuate over the next 11 months or so as the renewals are completed for the entire Medicaid population in Douglas County,” Johnson wrote.
In an April email, Johnson noted the state took steps to avoid “the cliff effect” by spreading renewals out over a 14-month period instead of all at once. The goal was to help Medicaid recipients remain eligible or, if not, help them gain health coverage with tax credits. At the end of the 14-month period, everyone currently receiving Medicaid will have been reassessed.
Fluctuations no surprise
Department of Health Care Policy & Financing spokesman Marc Williams said there’s a saying about changes in Medicaid: “If you’ve seen one Medicaid program, you’ve seen one Medicaid program.”
“This has been nothing surprising,” he said of the ups and downs of monthly registration numbers.
“Every county sees fluctuation from month to month although the numbers are bigger in the more populous counties,” he wrote in an email.
Williams also noted some Medicaid recipients can become eligible for the federal government’s other healthcare program, Medicare. Those who lose their Medicaid insurance are mailed notice of their coverage expiring at the end of their annual redetermination month.
Williams said counties receive Medicaid dollars based on their registration numbers but was not aware of how counties used that money. A county spokeswoman referred specific questions about how the county is financially impacted to William’s department.
State numbers show overall decline
A department website tracking monthly Medicaid renewals across Colorado noted renewals processed in the two years before the pandemic had an average of 41% lost coverage annually and 12% lost eligibility for procedural reasons. Another 29% did not requalify for reasons such as exceeding the income levels for their household size or eligibility classification.
The website reported 62,539 Colorado residents covered by Medicaid lost their coverage in June 2023, the latest figures available. Of those, 18,545 no longer qualified because their incomes exceeded limits based on their household size or eligibility classification. Some could have enrolled in employer-sponsored insurance.
Another 43,994 of those with June renewal anniversaries lost eligibility for procedural reasons. And 31,273 remained covered by Medicaid.