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Mar 11, 2020

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COVID-19 crisis underscores the critical role of ‘safety-net’ programs

by | Mar 11, 2020

Family Economic Security, Health

Amid the quarantines, illnesses, potential wage loss and anxiety associated with the coronavirus (or COVID-19), there’s clearly no “upside” to the epidemic. But the public health emergency does exemplify why safety-net programs are important — and can reveal how these programs and policies can be adjusted to serve Coloradans facing economic instability.

The emergency also shows why these programs play a critical role and could help Colorado’s residents through crises — whether related to illness or natural disasters like fires and floods as well as systemic circumstances beyond Coloradans’ control.

Looking at CCLP’s Focus Areas – food, health, housing and income – there are structures in place that will help the state manage this crisis, as well as gaps that may hamper those efforts. Two of Colorado’s most commonly used safety-net programs, Health First Colorado and Supplemental Nutrition Assistance Program (or SNAP) give Colorado communities the basic building blocks needed to manage and overcome problems that materialize during health crises and economic downturns, as well as the obstacles inherent in a system that disadvantages Coloradans of color and rural Coloradans.

Food – Events like the COVID-19 cause disruption to work when parents need to stay home with their children or slowdowns result in layoffs or fewer shifts. Coloradans who may find themselves temporarily out of work and without sufficient income can enroll online through Colorado PEAK without leaving home in the Supplemental Nutrition Assistance Program (or SNAP). The program ensures that families and individuals have funds to purchase groceries, with the average benefit being about $1.40 per meal, per person.

Unfortunately, hundreds of thousands of Coloradans in food-insecure households don’t access SNAP, leaving Colorado ranked 44th in terms of enrollment of eligible residents. The federal government funds SNAP dollars, and administrative costs are split between local, state and federal governments. CCLP is currently working with partners in the Colorado Blueprint to End Hunger coalition to improve SNAP outreach to one group that is under-enrolled, community college students.

Health – Coverage to identify and treat illness is an obvious need during a health crisis. Health First Colorado, the state’s Medicaid program, provides health coverage for over a million Coloradans, including people in nursing homes, people with disabilities, working adults, and – with the Child Health Plus (CHP+) program, close to half of Colorado children. Colorado expanded Medicaid eligibility in 2013 – providing hundreds of thousands of adults with incomes less than 133 percent of the Federal Poverty Level (FPL) with health insurance for the first time, with that coverage funded almost entirely by federal funds.

The 2013 expansion was a major step in the right direction and puts Colorado in a much better position than non-expansion states to address and contain COVID-19. Those non-expansion states universally have high rates of people without health insurance, leaving them at a disadvantage when identifying the spread of an illness is critical. The epidemic also makes it crystal clear why Medicaid block grants, which either limit expenditures per enrollee or limit enrollment, would make it fiscally impossible for a state to provide the level of care needed to all who need it during a crisis.

Short-term approaches in other states include increasing outreach to older participants and encouraging the use of telehealth for Medicaid enrollees, an effort we’d urge the state to adopt. Earlier this week, Gov. Polis also took the positive step of directing all health insurers in the state to waive co-pays, deductibles and other charges for those showing symptoms associated with the virus.

Even with expansion, however, CCLP has found that coverage rates may be declining. That is why we support House Bill 1236, which would use the regular tax-filing process to inform Coloradans of their eligibility for Medicaid, CHP+ and tax credits through the state exchange, Connect for Health Colorado. Bringing in those eligible Coloradans would help with future events, even if not for the current crisis.

Housing – In light of the virus scare, government officials in San Francisco and San Jose recently took action to halt evictions for tenants who are unable to pay rent due to coronavirus or following government-recommended coronavirus precautions. If the virus spreads, as expected, Colorado officials should seriously consider similar action – especially considering the high number of evictions already taking place in the state.

Income supports –  Regardless of the national situation, paid sick leave policies support economic security, better individual health and better public health, but fewer than a dozen states provide paid sick leave.  While there are no legislative proposals are active to require Colorado employers to give workers paid time off when they are sick, some members of Congress are trying to pass a new version of a sick leave bill and expand it to add 14 days of immediately available paid sick leave in the event of a public health emergency.

Even if the coronavirus doesn’t have a significant effect on the economy, and the spread isn’t nearly as devastating as public health officials fear, the aforementioned policies and programs ensure the health and well-being of Coloradans — whether they are facing the coronavirus, temporary setback, a recession or struggling with systemic challenges.

Please reference the Colorado Department of Public Health and Environment’s website for more resources and information about coronavirus disease 2019.

CCLP’s Health Program Director assisted with this posting. 

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Recent articles

CCLP testifies in support of TANF grant rule change

Apr 15, 2024

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.

CCLP’s legislative watch for April 5, 2024

Apr 5, 2024

For the 2024 legislative session, CCLP is keeping its eye on bills focused on expanding access to justice, removing administrative burden, preserving affordable communities, advocating for progressive tax and wage policies, and reducing health care costs.

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.