Apr 7, 2023

Bethany Pray serves as CCLP's Chief Legal and Policy Officer. Her areas of expertise include regulatory analysis and advocacy for Medicaid and commercial coverage, access to behavioral health benefits, Medicaid eligibility and much more.Staff page ›

Recent articles

CCLP testifies in support of Clean Slate updates

Bethany Pray, CCLP’s Chief Legal and Policy Officer, provided testimony in support of House Bill 24-1133, Criminal Record Sealing & Expungement Changes. CCLP is in support of HB24-1133, as it is one of our priority bills.

CCLP testifies in support of TANF grant rule change

CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

April Letter from Bethany Pray, Interim Executive Director

by | Apr 7, 2023

By the time this appears on your screen, the end of the Colorado legislative session will be in sight. The state budget will be wrapping up, many notable bills will already be signed into law or awaiting the Governor’s signature, and others will be posed to move through the second chamber. 

While the sprint of the session may soon be over, it’s now that we really have to roll up our shirtsleeves. The passage of a bill is a brief stage in the life of the policy. Metaphorically speaking, the session is where the rocket is built and put on the launch pad, but the session ends with the countdown just beginning. Whether we end up getting that photo of the flag unfurled on the moon — or the rocket disintegrates, runs out of fuel, or gets taken out by a (legal challenge) missile — is not always clear when it’s sitting on the launch pad. 

Inadequate fuel — aka money — is a big issue in Colorado. For example, legislation passed in 2019 was intended to create a wraparound program in Medicaid for kids — a set of intensive services designed to reach young people with acute needs during our ballooning behavioral health crisis. A year later, the economic impacts of COVID loomed and funding was withdrawn. Four years later, that intensive behavioral health service is still not in place for the families that are struggling with kids with severe mental health issues. Instead of getting community-based care, these kids are in hospitals and emergency departments, detention facilities, and on the street. That rocket has yet to launch. 

And then there are the missiles. The Affordable Care Act, passed in 2010, encourages people to get preventive services — by eliminating copays or other cost-sharing — enabling earlier detection of diabetes, cancers, or potential birth complications. Anyone who wanted to reduce long-term costs or save people the agony of advanced disease cheered this policy, and it has become foundational in the structures for public and commercial coverage. But even at this late stage — thirteen years later — a decision issued by a lone judge could threaten the validity of the full list of cost-free preventive services. While plans are safe for 2023, we’ll have to see how this affects future coverage. 

Other bills continue on their path, though, thanks to thoughtful and well-attended rulemaking and stakeholder processes over the past two years. Hospital Discounted Care, enacted through House Bill 21-1198, has seen the benefits of ongoing engagement by CCLP and our legal and health-advocacy partners, who have kept the focus on industry compliance with provisions that require screening for public programs and discounts on hospital bills. More advocacy is to come, along with training for attorneys as enforcement ramps up.  

Likewise, the Colorado Option standardized health plan, created by HB21-1232, had a banner first year, with higher-than-expected enrollment due to strong state rule-making and spectacular informational campaigns by the Center for Health Progress and the Colorado Consumer Health Initiative, among others. Ten-thousand Coloradans who couldn’t previously qualify for subsidized coverage now, in 2023, have OmniSalud plans and meaningful access to services. 

The passage of a bill matters. But whether you think of it as a rocket on the launchpad, a first word in a sentence or even a bit of green emerging from the soil in spring, the passage of a bill isn’t an ending, but a beginning. This legislative session is shaping up to be cause for celebration. Much more is still to come, with ample opportunity for Coloradans to affect the future state of things — by attending those open meetings, weighing in on rules, giving support to groups that dig into implementation, asking your legislator to support ongoing funding, or filing grievances and appeals to let the state know what’s not working. We’re nearly go-for-launch, but it will take all of us to get to the moon.

Recent articles

CCLP testifies in support of Clean Slate updates

Bethany Pray, CCLP’s Chief Legal and Policy Officer, provided testimony in support of House Bill 24-1133, Criminal Record Sealing & Expungement Changes. CCLP is in support of HB24-1133, as it is one of our priority bills.

CCLP testifies in support of TANF grant rule change

CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.