News

Mar 2, 2017

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Allison Neswood previously served as CCLP's Deputy Director of Strategic Priorities. She is an expert in public health insurance plans (Medicaid and CHP+), Aid to the Needy Disabled, immigrant access to services and health equity.

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Why Medicaid Works

by | Mar 2, 2017

Health

Congressional opponents of the Affordable Care Act appear to be increasingly uneasy about repealing the law’s major provisions without a replacement plan that preserves health coverage for millions of Americans.

As the health care debate shifts, it is important for lawmakers to understand that while the ACA and our health system as a whole can certainly be improved, the Medicaid program works.

In light of Congressional proposals to cap federal funding for Medicaid, Colorado Center on Law and Policy has compiled Medicaid Works, a series of fact sheets that demonstrate why cuts to federal Medicaid funding would be bad for Colorado.

The fact sheets cover the importance of Medicaid to: children’s health, women’s health, older Coloradans, Coloradan’s with disabilities and Coloradans struggling with substance-use disorders. Other sheets examine the systemic benefits of Medicaid, including the benefits to Colorado’s economy, Colorado’s health system and Colorado’s rural communities.

Nationally, Medicaid provides health coverage to 65 million low-income and disabled Americans. Medicaid covers populations with higher health needs on average, yet the program pays less money for more services than private insurers.Medicaid’s administrative costs are less than half the administrative costs of private insurance plans. Per-enrollee growth in Medicaid spending has been slower than in the private insurance market. Medicaid services support the health and financial security of low-wage workers, promote the healthy development of children living in low-income households and allow disabled Americans to access the services and supports they need to attend school, work and live in their communities.

Health First Colorado, Colorado’s Medicaid program, serves low-income Coloradans and Coloradans living with disabilities. In addition, federal funding for Health First Colorado boosts the state economy, contributes millions of dollars to the state’s health care budget and stabilizes Colorado’s health system while allowing the state to invest in innovative health reform efforts that increase the value of health care.

The existing formula for federal Medicaid funding is critical to Health First Colorado’s sustainability. Currently, federal law requires the government to cover at least half of the cost of providing services for those enrolled in Health First Colorado. For those who receive coverage as a result of the ACA’s Medicaid expansion, over 90 percent of the program’s costs are paid by the federal government. Capping federal funding for Health First Colorado by converting the funding into a block grant or a per-capita cap would eliminate those guarantees and prohibit federal Medicaid funding from growing in a matter that adequately tracks growth in costs or unusual health events.

Current proposals to cap Medicaid funding aim to shrink the program by 25 to 30 percent nationally, reducing the federal government’s contribution to state Medicaid programs by $1 trillion dollars over the next 10 years. Drastic cuts in that funding will shift the cost of providing care to Colorado and require substantial increases in the state’s General Fund spending on Health First Colorado or trigger substantial cuts to eligibility, services, provider reimbursement rates, or a combination of the three.

Though the threat to Medicaid is real, there’s still time to persuade members of Colorado’s Congressional delegation to consider the value and importance of the program for Coloradans and the state’s health and well-being.

Contact your representatives and ask them to protect Health First Colorado.

–Allison Neswood

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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.