Mar 6, 2023

Bethany Pray currently serves as CCLP's Deputy Director. 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 ›

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March Letter from Bethany Pray, Interim Executive Director

by | Mar 6, 2023

March brings change. The session is nearing the halfway point, the sub-zero temperatures are over in Denver — we hope! — and over the next four weeks, the thousands of fiscal decisions that go into the budget will come together and the legislative landscape will begin to take shape — almost as predictably as the daffodils, the start of spring training, and the exploding of the rabbit population in my front yard.

It is also predictable, you might say, that CCLP’s work this session focuses on the fundamentals: economic opportunity and better health. Provocative or headline-grabbing? Not necessarily. But the right policy changes can lower the unreasonable obstacles that low-income households confront when they are seeking better jobs or a better place to live or affordable health care. That can be life-changing for individuals. And those efforts have momentum, with all three of these CCLP priorities flying through their first committees on unanimous votes, thanks to the support of the community members who devoted their time to testifying, our fellow advocacy groups, and dedicated sponsors.  

As convener of Skills2Compete, a multi-sector coalition centered on jobs, workforce and skills training, CCLP is helping lead House Bill 1124, which ensures continued funding for employment support and job retention for people receiving food assistance or SNAP, with the $1.5 million in state dollars matched by the same amount of federal funds.  CCLP is also hard at work on another Skills2Compete priority, Senate Bill 007, a bipartisan bill that aims to address the appallingly poor funding for adult education in Colorado, and to better meet the needs of the tens of thousands of adults who lack a high school diploma. Colorado currently ranks 6th lowest nationally in funding for adult education, with just $7 of funding per each eligible adult.  

Our health priorities are similarly fundamental. With House Bill 1126, CCLP aims to address the impact that medical debt – a burden that no one intends to take on – has on people’s ability to rent, get work, and get a loan with reasonable terms, by preventing that debt from being included on credit reports. Not only are reports of medical debt often inaccurate, but marginalized communities are saddled with higher levels of medical debt, and when included on credit reports, the debt has ripple effects that can last for decades.  In Colorado alone, residents have $1.9 billion in medical debt, a clear sign of systemic failures in the way medical care is covered and delivered. At the same time, we successfully pushed for counties and the state appeals system to get more funding to better manage the end of continuous coverage in Medicaid. Hundreds of thousands of people will have to transition to other coverage, but no one who still meets eligibility requirements should have to face a gap in care. 

None of us wants hundreds of thousands of Coloradans to be left behind – people who lack access to education or training, or are burdened by medical costs and their long-term impacts –  because it’s clear that how our neighbors and communities fare affects all of us. We can make it possible for parents to get the education they need to support their own children’s schooling, to understand bills or lease requirements, to acquire the digital literacy skills that daily life requires, and to get good jobs. We can ensure that people who end up with medical debt because of a catastrophic health event or unreasonable hospital charges aren’t haunted by that long-term when they seek to start a business or buy a home. We can keep people covered by Medicaid. Among the hundreds of bills already introduced, there are also some that would foreclose people’s opportunities, like bills that criminalize addiction instead of making treatment more available, and those are well worth fighting. 

However, it’s also important to keep in mind: we’re not yet at the half-way point of the session, and there are still more bills to come. In fact, some major bills are just now emerging in the health sphere, and we’ll be doubling down on ensuring that proposed changes to the law positively effect the experiences of patients and families, both financially and personally. 

Coloradans are inventive and resourceful, but too many lack the opportunity to move their dreams forward. By prioritizing bills that create opportunity and stopping those that squelch it, we’ll all be able to benefit from what they have to offer. 

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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.


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.


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.


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.