Enrolling More Uninsured Colorado Children

Colorado is chipping away at the number of uninsured children who are eligible for public health insurance through Medicaid or the Child Health Plan Plus (CHP+) but aren’t enrolled.

An annual count by the Colorado Health Institute shows that the number of these children – referred to as eligible for but not enrolled or EBNE - is about 80,000, down more than 10 percent from last year’s count.

This is an important yearly measure of efforts across Colorado by state government as well as advocacy organizations to ensure that Colorado’s most vulnerable children have the benefit of health insurance and better access to medical care.

Two important policy changes impacted the calculation of the latest EBNE estimates, which are based on the latest available data from 2012.

First, in 2013 Colorado eliminated the so-called “stair step” in Medicaid and CHP+ that often resulted in children in the same family qualifying for different insurance. Now, all children must meet the same family income criteria, regardless of age. This change means that more Colorado children are eligible for Medicaid and fewer are eligible for CHP+.

Second, a new method of determining net income– called Modified Adjusted Gross Income or MAGI – became effective in 2014, changing Colorado income eligibility levels.

For this analysis, the Colorado Health Institute used these eligibility standards:

Medicaid: Up to and including 147 percent FPL

CHP+: Between 148 percent and 265 percent FPL

Because of these policy changes, we modeled this year’s EBNE count two ways – a “before” method without incorporating the changes and a “current” method that incorporates the changes and allows for better comparison moving forward.

Under the “before” method, about 77,500 children are EBNE. Under the “current” method, about 81,600 children are EBNE.

Importantly, the number of EBNE children declined between 2011 and 2012 under both scenarios. This may be a testament to outreach and enrollment efforts as well as economic and demographic factors. 

With the decline in EBNE children, we saw a big spike between 2011 and 2012 in the number who became insured through Medicaid or CHP+ - an increase of about 44,600 to 430,700 from 386,100.

In addition to the fact sheet with the 2014 updates, a data supplement is available, as well as the methodology.

EBNE Kids

Natalie Triedman is a policy analyst at CHI.