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June 10, 2014

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Letter: Connect for Health Colorado Proposed FY2015 Budget

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Board of Directors
Connect for Health Colorado
3773 Cherry Creek N Dr.
Denver, CO 80209
RE: Connect for Health Colorado Proposed FY2015 Budget
On behalf of the Colorado Consumer Health Initiative and the Colorado Center on Law and Policy, we submit this letter in support of the Connect for Health Colorado (C4HCO) proposed Fiscal Year 2015 budget. This budget, up for consideration by the Board of Directors on Monday, June 9, 2014, makes key investments in technology infrastructure and consumer assistance that is essential to achieving the mission of C4HCO. We support the adoption of the budget and in particular several essential priorities.
The proposed budget includes a critical investment of $5.58 million to develop a shared eligibility system between the Department of Health Care Policy and Financing and C4HCO. CCHI, CCLP and partner organizations learned through our Consumer Engagement Project, the results of which we have shared with C4HCO in previous issue briefs, that the two-track application was a hindrance to enrollment. Having two separate applications for Medicaid and Advanced Premium Tax Credits was one of the more significant hurdles to a streamlined, consumer-friendly enrollment process. The eligibility technology upgrade will facilitate a more seamless enrollment experience, simplify training for Health Coverage Guides and other enrollment assisters, save consumers valuable time, and eliminate one more obstacle to accessing coverage.
In addition, the 2015 budget proposal allocates necessary funding to one of the greatest C4HCO assets – the Assistance Network. The enabling legislation that established C4HCO emphasized the intent to increase access to health insurance for Coloradans. The Assistance Network is the foundation to fulfilling this charge. Health Coverage Guides are connected at the roots of our communities throughout Colorado and are trusted ambassadors for C4HCO. Beyond that, they are trusted advocates for health – helping Coloradans access coverage through C4HCO but also Medicaid and the Child Health Plan Plus. Enrolling 46,000 people in health coverage, whether private or public insurance, is a significant achievement by the Assistance Network.
Our Consumer Engagement Project survey data also demonstrated that a culturally diverse assistance network is essential for enrolling key populations including Latinos, African Americans and Asian Americans. While difficult to measure, Health Coverage Guides working in these communities did crucial outreach to raise awareness. For instance, a greater proportion of Hispanic survey respondents learned about C4HCO through a community organization or event than non-Hispanics. Assistance Network outreach efforts that catalyze enrollments are less easily quantified, but they are no less important to evaluating the effectiveness of the network. We know the Assistance Network is working, and the proposed budget ensures that vital work can continue. As in the past, we continue to urge C4HCO to consider ways to accurately measure and evaluate the performance of the network to improve its reach.
We further support the proposed 1.4% administrative fee, among the lowest in the country, as well as the broad market assessment on carriers of $1.25 per member per month. These revenue streams will ensure the sustainability of the marketplace. Furthermore, not only is the assessment well below the assessments that have long been in place to fund Cover Colorado, but it is also consistent with the diligent efforts in Colorado to ensure a level playing field between C4HCO plans and those sold outside the marketplace.
We thank you for your continued stewardship of Colorado’s health insurance marketplace.
Colorado Consumer Health Initiative
Colorado Center on Law and Policy


Date added

June 10, 2014

Resource type

Filed under


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.