Publications
Community-Driven Policy cohort 2023 summary report

Community-Driven Policy cohort 2023 summary report

The Community-Driven Policy (CDP) Pilot Project, advanced by Sister Carmen Community Center, Emergency Family Assistance Association, Community Resource Center, and CCLP explored how to equitably engage community members to help shape the policy and advocacy-making space. The process included identifying a key community issue and creating solutions at the local or state level that are centered in community priorities.
Issue brief: Medicaid eligibility and wages

Issue brief: Medicaid eligibility and wages

Colorado, like other states across the country, has seen increases in the state minimum wage since the start of the COVID-19 pandemic. Colorado has also seen high rates of disenrollment from Medicaid, particularly since the end of the COVID-19 Public Health Emergency (a process known as the PHE Unwind.) The increase in the state minimum wage has been proposed as an explanation for the high rate of disenrollment. However, our analysis leads us to believe that there are other, more significant factors that explain why Colorado’s disenrollment rate is so high compared to other states in the country. Using data from the Bureau of Labor Statistics and KFF (who collected their data from the Centers for Medicare and Medicaid Services), we examine how wage increases since 2019 might have influenced a low-wage workers eligibility for Medicaid, and how wages changes in other states compared to their disenrollment rates in order to better understand the relationship between wages and Medicaid enrollment across the country. Using statistics, we can quantify the relationship between wages and disenrollment rates to determine how changes in wages explain — or don’t explain — the variation we see in states’ Medicaid disenrollment rates.
June 2024 Joint Budget Committee presentation on PHE Unwind

June 2024 Joint Budget Committee presentation on PHE Unwind

On June 20, 2024, CCLP's Chief Legal and Policy Officer Bethany Pray joined a panel assembled by the Colorado Health Policy Coalition, to testify on the subject of the COVID-19 Public Health Emergency (PHE) Unwind. This resource document provides the talking point notes of the presentation given by Ms. Pray, including citations, to assist in clarifying and dispelling the rumors and assumptions that have beset discussions of Medicaid enrollment.
Community Testimony Guide / Guía de Testimonio Comunitario

Community Testimony Guide / Guía de Testimonio Comunitario

Testifying is an important way for any member of the public to get involved in the legislative process and shape the bills that become laws in our state. A testifier explains an issue and lets legislators know how a bill will impact real people. Learn more about how to testify in our Community Testimony Guide. This guide was prepared for Colorado’s 2024 legislative session. Available in English and Spanish. Testificar es una forma importante para que cualquier miembro del público se involucre en el proceso legislativo y dé forma a los proyectos de ley que se convierten en leyes en nuestro estado. Un testificante explica un problema y les hace saber a los legisladores cómo un proyecto de ley afectará a personas reales. Aprende más sobre cómo testificar en nuestra Guía de Testimonio Comunitario. Esta guía fue preparada para la sesión legislativa de Colorado de 2024. Disponible en inglés y español.
Medical Debt & Your Credit Report: Know Your Rights Resources / La deuda médica y su informe de crédito: Recursos para conocer sus derechos

Medical Debt & Your Credit Report: Know Your Rights Resources / La deuda médica y su informe de crédito: Recursos para conocer sus derechos

Thanks to a new law in Colorado, your credit report can’t include information about your medical debt anymore. This means your unpaid medical bills won’t affect your credit score. CCLP and our partners have created a fact sheet and guide to consumer rights to help you understand your rights under the new law. Available in English and Spanish. Gracias a una nueva ley en Colorado, su informe de crédito ya no puede incluir información sobre su deuda médica. Esto significa que sus facturas médicas no pagadas no afectarán su puntaje de crédito. CCLP conjunto con otras organizaciones hemos creado una hoja informativa y una guía de los derechos de los consumidores para que entiende sus derechos bajo la nueva ley.  Disponible en inglés y español.
CCLP Annual Report 2022

CCLP Annual Report 2022

Colorado Center on Law and Policy releases its annual report each year to share stories of impact from the past year, to affirm our mission and progress toward our vision of a Colorado in which everyone has what they need to succeed,  to provide financial statements indicating the fiscal health of the organization, and to acknowledge the many funders and philanthropic organizations who make our work possible.
Medicaid Appeals Guides / Las Guías de apelaciones de Medicaid

Medicaid Appeals Guides / Las Guías de apelaciones de Medicaid

With the end of continuous coverage requirements in Medicaid looming ever closer, we expect at least 350,000 Coloradans will lose their Medicaid coverage over the course of the next year. This series of 3 Medicaid Appeals Guides is designed to help community members better understand their rights and how best to utilize these resources. NOTICE: This updated version of the guide is based on the latest state policies and guidance as they were understood on March 4, 2024. However, those policies may be subject to further change. Check this website for future policy updates: copolicy.org/medicaidappeals
Amicus Brief: French v Centura Health

Amicus Brief: French v Centura Health

Amicus brief filed by Colorado Consumer Health Initiative (CCHI), Colorado Center on Law and Policy (CCLP); and Colorado Legal Services (CLS) on June 25, 2021, on behalf of the plaintiff in French v Centura Health. on May 16, 2022, the Colorado Supreme Court unanimously reversed the lower court’s opinion, holding that Ms. French could not agree to a price term that was never disclosed to her. The Court also noted that Centura had refused to even turn over the chargemaster during the course of the litigation. The result of this case was a victory for advocates fighting against predatory hospital billing practices.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

Health First Colorado is the name given to Colorado’s Medicaid program. Medicaid provides public, low-cost health insurance to qualifying adults and children. It is an entitlement program funded by the federal, state, and county governments and is administered by counties in Colorado. Those who are required to pay must pay a small co-pay when receiving certain health care services.

State Department: Department of Health Care Policy and Financing

Eligibility: Most adults 18 to 64 are eligible for Medicaid in Colorado if their household income is at or below 133% of the federal poverty limit (FPL). Pregnant women are eligible with incomes of up to 195% FPL, while children under 18 may be eligible if the live in a household with income at or below 142% FPL. Some adults over 65 may also be eligible for Medicaid.

Program Benefits: Through Medicaid, low-income Coloradans are eligible for a range of health care services at little to not cost. Services provided include doctors visits, prescription drugs, mental health services, and dental care. Co-pays for certain individuals may be needed for certain services.

Program Funding and Access: Colorado funds our Medicaid program through state and federal dollars. Medicaid is an entitlement program, which means that all who are eligible for Medicaid can access the program, regardless of the funding level in a given year. This does not mean that it is always easy to access Medicaid, even when eligible. And since the program is administered by counties, funding levels for county staff and other administrative roles can make it easier or harder for Coloradans to access the program. On top of this, not all medical providers accept Medicaid which limits the ability of Coloradans to seek health services even if enrolled, such as if the nearest provider is a 2+ hour drive away.

Note: This data is from before the pandemic and does not reflect changes in enrollment rules during the COVID-19 pandemic and public health emergency.

Statewide Program Access 2015-19: Over the study period of this report, an average of 89.0% of the population at or below 133% of FPL (i.e., the population who is likely to be eligible for Medicaid) were enrolled in Medicaid in Colorado.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

The Supplemental Nutrition Assistance Program or SNAP helps low-income Coloradans purchase food by providing individuals and families with a monthly cash benefit that can be used to buy certain foods. SNAP is an entitlement program that is funded by the federal and state governments and administered by counties in Colorado.

State Department: Department of Human Services

Eligibility: Currently, Coloradans qualify for SNAP if they have incomes below 200% FPL, are unemployed or work part-time or receive other forms of assistance such as TANF, among other eligibility criteria. Income eligibility for SNAP was different during the study period of this report than today—it was 130% FPL back in 2019 for example. The US Department of Agriculture uses the population at or below 125% FPL when calculating the Program Access Index (or PAI) for SNAP. We follow this practice in our analysis despite Colorado currently having a higher income eligibility threshold.

Program Benefits: SNAP participants receive a monthly SNAP benefit that is determined by the number of people in their household and their income. Benefit amounts decrease as income increases, helping households avoid a sudden loss of SNAP when their incomes increase, even by a minor amount. Benefits are provided to an Electronic Benefit Transfer (EBT) card that can be used to purchase eligible food items, such as fruits and vegetables; meat, poultry, and fish; dairy products; and breads and cereals. Other items, such as foods that are hot at their point of sale, are not allowable purchases under current SNAP rules.

Program Funding and Access: SNAP, like Medicaid, is a federal entitlement program. This means that Colorado must serve any Coloradan who is eligible for the program. As such, funding should not be a limit to how many Coloradans can be served by the program. However, funding for administration of SNAP at the state and county level can limit the ability of county human service departments to enroll those who are eligible. Other program rules and administrative barriers can make it difficult for Coloradans to receive the benefits they are legally entitled to receive.

Statewide Program Access 2015-19: Over the study period of this report, an average of 61.1% of the population at or below 125% of FPL (i.e., the population who is likely to be eligible for SNAP) were enrolled.

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

The Special Supplemental Nutrition Program for Women, Infants, and Children, also know as WIC, provides healthcare and nutritional support to low-income Coloradans who are pregnant, recently pregnant, breastfeeding, and to children under 5 who are nutritionally at risk based on a nutrition assessment.

State Department: Department of Public Health and Environment

Eligibility: To participate in WIC you must be pregnant, pregnant in the last six months, breastfeeding a baby under 1 year of age, or a child under the age of 5. Coloradans do not need to be U.S. citizens to be eligible for WIC. In terms of income, households cannot have incomes that exceed 185% FPL. Families who are enrolled in SNAP, TANF, Food Distribution Program on Indian Reservations (FDPIR), or Medicaid are automatically eligible for WIC. Regardless of gender, any parents, foster parents, or caregivers are able to apply for and use WIC services for eligible children.

Program Benefits: WIC provides a range of services to young children and their parents. These include funds to purchase healthy, fresh foods; breastfeeding support; personalized nutrition education and shopping tips; and referrals to health care and other services participants may be eligible for.

Program Funding and Access: WIC is funded by the US Department of Agriculture. The state uses these federal funds to contract with local providers, known as WIC Clinics. In most cases, these are county public health agencies, but that is not the case in all Colorado counties. Some WIC Clinics cover multiple counties, while others are served by multiple clinics. Private non-profit providers are also eligible to be selected as a WIC Clinic.

Statewide Program Access 2015-17: Between 2015 and 2017, an average of 52.2% of the population eligible for WIC were enrolled in the program in Colorado.

Financial Security:
Colorado Works

Colorado Works is the name given to Colorado’s program for Temporary Assistance to Needy Families or TANF. It is an employment program that supports families with dependent children on their path to self-sufficiency. Participants can receive cash assistance, schooling, workforce development and skills training depending on the services available in their county.

State Department: Department of Human Services

Eligibility: In general, Coloradans are eligible to enroll in TANF if they are a resident of Colorado, have one or more children under the age of 18 or pregnant, and have very low or no income. For example, to be eligible to receive a basic cash assistance grant through TANF, a single-parent of one child could not earn more than $331 per month, with some exclusions—and would only receive $440 per month (as of 2022). That said, there are other services provided by counties through TANF that those with incomes as high as $75,000 may be eligible for. In addition to these, participants in TANF are required to work or be pursuing an eligible “work activity” or work-related activity. Any eligible individual can only receive assistance if they have not previously been enrolled in TANF for a cumulative amount of time of more than 60 months—this is a lifetime limit that does not reset. Counties may have additional requirements and offer benefits that are not available in other counties in Colorado.

Program Benefits:  While the exact benefits that one is eligible for under TANF can vary, all qualified participants are eligible to receive a monthly cash payment, call basic cash assistance. Other than cash assistance, counties are have a lot of choice in how to use their TANF funding; generally a use of TANF funds is appropriate so long as it advances one or more of the four purposes of the program: (1) provide assistance to needy families so that children can be cared for in their own homes or in the homes of their relatives; (2) end the dependence of needy families on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out-of-wedlock pregnancies; and (4) encourage the formation and maintenance of two-parent families.

It is important to note that those eligible for TANF are also eligible for many of the other programs we’ve included in this report, such as SNAP, Medicaid, and CCCAP.

Program Funding and Access: Colorado funds its TANF program through funds received from the federal government through the Temporary Assistance for Needy Families block grant. Most of the federal funds are allocated by the state to counties, which are required to provide a 20% match of state funding. Federal and state rules allow the state and counties to retain a portion of unspent funds in a TANF reserve.

Statewide Program Access 2015-19: Over the study period of this report, an average of 50.7% of the population at or below 100% of FPL (i.e., the population who is likely to be eligible for TANF) were enrolled in TANF in Colorado.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

The Colorado Child Care Assistance Program provides child care assistance to low-income families and caregivers living in Colorado in the form of reduced payments for child care. It is a program funded by the federal, state, and county governments and is administered by counties in Colorado. The share owed by parents/caregivers is determined on a sliding scale based on the family’s income.

State Department: Department of Early Childhood Education

Eligibility: Counties set eligibility for families separately, but must serve families with incomes at or below 185% of the Federal Poverty Limit. Families accepted to the program are no longer eligible once their income exceeds 85% of the state median income. Parents or caregivers must be employed, searching for work, or engaged in another approved activity to be eligible for CCCAP. Parents and caregivers enrolled in Colorado Works (Temporary Assistance to Needy Families or TANF) or in the child welfare system are also eligible to participate in CCCAP. Generally, CCCAP serves families with children under 13, although children as old as 19 may be eligible under certain circumstances.

Program Benefits: If a family is eligible for CCCAP and has income, they may likely have to pay a portion of their child’s or children’s child care costs each month. The amount that families owe is based on their gross income, number of household members, and the number of children in child care in the household. As such, households tend not to experience a benefit cliff with CCCAP when they see their incomes increase

Program Funding and Access: Colorado funds the CCCAP program using federal dollars it receives from the Child Care and Development Block Grant program. The state allocates federal and state funds to counties using a formula that takes into account factors like current caseloads and the number of eligible residents. Assistance is available until the county’s funds are spent, so the number of families that can be served is often a function of how much funding is available and the income and composition of the household that applies. It is not uncommon for counties to overspend or underspend their allocations of funds. The state reallocates unspent funds from counties who underspent to those who overspent. While underspending could indicate a problem with the way a county administers its CCCAP program, it could just as likely be a sign that there are few providers in the county who participate in CCCAP—or a lack of providers generally.

Statewide Program Access 2015-19: Over the study period of this report, an average of 10.8% of the population at or below 165% of FPL and younger than age 13 (i.e., the population who is likely to be eligible for CCCAP) were enrolled in CCCAP.

Housing:
HUD rental assistance programs

The US Department of Housing and Urban Development (HUD) has three housing assistance programs that we look at together: Housing Choice Vouchers (Section 8), Project-based Section 8, and Public Housing. In Colorado, these programs provided assistance to over 90% of the households who received federal housing assistance from all HUD programs. Through federally funded, local or regional public housing agencies (PHAs) are the agencies that administer these programs, through not all are available in all counties. These are not the only programs available in Colorado that assist households afford the cost of housing, such as units funded through federal and state tax credit programs.

State Department: Department of Local Affairs

Eligibility: Generally, households with incomes under 50% of the area median income (AMI) of the county they live in are eligible for these rental assistance programs, although PHAs have discretion to select households with incomes at higher percentages of AMI. That said, HUD requires that 75% of new vouchers issued through the Housing Choice Voucher/Section 8 program in a given year are targeted to households with incomes at or below 30% of AMI. PHAs are also able to create criteria that give priority to certain types of households who are on waiting lists for these programs.

Program Benefits: These rental assistance programs help households afford the cost of housing by reducing their housing costs to around 30% of their household income. In the case of the Housing Choice Voucher program, the PHA pays the voucher holder’s landlord the remaining portion of the rent.

Program Funding and Access: Funding and access are both challenges for these rental assistance programs. In addition to limitations on the number of public housing units or housing vouchers a PHA can manage or issue, lack of funding compared to the need constrains the ability of PHAs to assist low-income households. In 2020, Coloradans were on waitlists for Housing Choice Vouchers for an average of 17 months. Waitlists also exist for the other rental assistance programs.

Statewide Program Access 2015-19: Over the study period of this report, an average of 21.1% of renter households with incomes at or below 50% AMI (i.e., the population who is likely to be eligible for HUD rental assistance programs) were living in subsidized housing.