Older Coloradans Were Healthy, Medicare Access Was a Major Factor

While Colorado’s older adults were more likely to be white than younger adults (84.6% of 65+, compared to 65.6% of ages 18-64), a little more than one in 10 (15.4%) were Black, Hispanic/Latino, or some other race, and 6.6% spoke a language other than English at home. 

In 2023, 95.0% of adults 65 and over were covered by publicly funded insurance, including Medicare and Medicaid. About 4.5% were covered by private insurance (employer-sponsored or individual) or another insurance type. In contrast, less than a third of adults ages 18-64 were covered by public insurance (28.8%), a majority of whom got their coverage through Medicaid.  And 6.2% of adults ages 18-64 were uninsured.

Older Coloradans Report Good Health

Despite prevailing stereotypes about health and aging, Coloradans across generations report similar levels of good general health. More than eight in 10 (81.4%) Coloradans 65 and older said they were in excellent, very good, or good health. 

In addition to overall health, older adults reported high rates of good mental health, defined by this survey as fewer than eight days in the past month of stress, depression, or problems with emotions. Among Coloradans 65 and older, a majority (89.9%) said they had good mental health compared with younger adults (67.4% for ages 18-64).  

While this is promising news for older Coloradans, reporting mental good health and having good mental health are not the same. Older people grew up in a time when talking about mental health was taboo. They may not consider depression or anxiety related to their mental health. And, they also may feel more stigma about mental health problems or asking for help.  

Similarly, older Coloradans may dismiss feelings of anxiety or depression and changes in their general health as a normal part of aging.  The CHAS cannot gauge whether older Coloradans’ report better health based on their own expectations of what their health should be for their age. They may report very good or excellent health, because they’re comparing their current health to an internally held stereotype. 

Older Coloradans Experienced Fewer Barriers to Care

Use of Care

A higher percentage of Coloradans 65 and older visited their doctors compared with younger Coloradans, likely because when they had a health concern, they had the insurance to get the care they needed. About nine in 10 adults in this age group (91.1%) visited a doctor during the previous 12 months, compared with 77.8% of the younger group. More than seven in 10 (71.3%) older adults sought care from a specialist compared with 49.6% of 18-to-64-year-olds.

Older adults used telemedicine almost as much as younger ones (37.8% compared with 39.7%). The COVID-19 pandemic made telemedicine more available and appealing to older Coloradans. Medicare also took steps to cover telehealth services, making them financially viable for providers. More recent legislation made some of those changes permanent and extended others through 2024. 

Typical Barriers to Care

Having insurance does not mean that all health care services are affordable, but public insurance does seem to reduce the cost burden for older Coloradans. Five times as many adults ages 18-64 (15.4%) did not visit the doctor for needed care due to cost, compared with adults 65 and over (2.9%). 

One in five (19.2%) adults ages 18-64 did not get specialty care due to cost, compared with fewer than one in 20 adults in the 65+ group (4.9%). And twice as many younger Coloradans reported trouble filling a prescription due to cost (14.7% of 18- to 64-year-olds) compared with older adults (6.1%).

Compared with barriers for younger adults, Coloradans 65 and older had substantially fewer issues accessing care. The ability of Coloradans to get an appointment as soon as they thought one was needed was less of an issue for older adults (20.8%) than for younger ones (32.9%). Coloradans over 65 and older were told less often that the doctor’s office or clinic was not accepting new patients (6.3% compared with 13.4% for 18-64). And older Coloradans were seldom told by providers that they did not accept their type of insurance (4.2% for 65+ compared with 13.4% for 18-64).

While older adults experience fewer barriers to care compared to younger Coloradans, many face challenges using their benefits. Insurance coverage and benefits are confusing, and public insurance plans are no exception. A 2023 KFF study showed that 51% of adults insured through Medicare and 58% of adults insured with Medicaid experienced a problem using their health insurance in the past 12 months. These problems included insurance covering less for care than expected, provider network issues, difficulty receiving preauthorization for needed care, prescription drug coverage, and others. Helping older adults better understand their Medicare and Medicaid benefits could encourage members to use their benefits.

Older adults were less likely than younger adults to report needing culturally competent care to meet their health care needs (5.2% compared with 15.1%). However, this still represents nearly 41,000 older adults who reported that they had some characteristic — such as their language, race, religion, culture, gender identity, among others — that affects the kind of care that they need.

Older Coloradans Still Face Challenges

Coloradans 65 and older reported that physical, mental, or emotional conditions limited their daily activities at about the same rate as younger generations (19.1% compared with 16.0% for 18- to 64-year-olds). Rates did differ, though, for Colorado’s oldest adults. By age 79, about a third of Coloradans (30.2%) reported limited daily activities. Even so, two in three Coloradans in that age group said they had no difficulty performing daily activities. Either they are not experiencing those challenges, or they believe they are managing them well on their own or with the help of loved ones. 

The percentage of Coloradans reporting housing and food insecurity decreased with age, but still represented a large number of people. Many older Coloradans live on fixed incomes, so increases in food or housing costs quickly become a concern. Among Coloradans 65 and older, 2.2% worried they would not have stable housing in the next two months (compared with 9.4% in the 18-64 group) and 4.5% ate less than they felt they should because they could not afford food (compared with 14.9% in the 18-64 group).   

Implications

One in five Coloradans — about 1.3 million people — will be over the age of 65 by 2035. But that shouldn’t scare us. Access to Medicare and Medicaid programs in Colorado makes a difference to the health of older Coloradans and reduces their barriers to getting care. 

But obstacles still exist. Policymakers should continue to look for ways to keep the cost of care down, especially for prescription drugs, which would help Coloradans regardless of age.

Health care systems have an opportunity to improve their ability to provide culturally responsive care by diversifying their workforce. And insurance providers should consider a variety of ways to help their patients and members understand the benefits they provide.