The percentage of Coloradans who are uninsured remains at 6.5%, unchanged from two years ago, while the number of uninsured Latino children has spiked, according to the 2019 Colorado Health Access Survey.

Calling the stable uninsured rate “striking” given the health of the state’s economy, the survey previously measured a steep drop in the rate since the full implementation of the federal Affordable Care Act, from 13.5% uninsured in 2009 to 6.7% in 2015. The expansion of Medicaid and development of a subsidized marketplace were two major factors.

Low-income households are experiencing their lowest rates of being uninsured compared to historical averages. However, 54,145 children remain uninsured, and Latino children made up the large portion of the increase. A “public charge” proposal from the Trump administration that affects whether immigrants apply for public benefits may be a disincentive to health care access.

Ross Brooks of Mountain Family Health Centers, also believes that anti-immigrant rhetoric nationally has discouraged Latino families from enrolling their children in insurance, even if those kids are U.S. citizens.

“The fear hasn’t gone away,” he said. “It’s gotten worse.”

The CHAS, a product of the research organization Colorado Health Institute, is administered to 10,000 people in English and Spanish every two years. The survey also measured the barriers people encounter in receiving care.

Depending on the type of insurance they had, between 7.6% and 20% of respondents did not get medical care because a doctor did not accept their plan. Similar numbers of people, between 7.5% and 15.7%, did not see a specialist because of cost. More than 30% of Coloradans reported receiving a surprise medical bill.

“This year’s CHAS results are a warning sign: Too many Coloradans can’t afford or access the health care they need, and too many don’t have the things they need to live a healthy life, including secure housing, food, and health insurance,” said Jeff Bontrager, director of research and evaluation at CHI.

The percentage of people who reported not getting needed mental health care nearly doubled, from 7.6% in 2017 to 13.5% in 2019 — although fewer people cited cost as a barrier than in past years. A new “SEE ME” campaign debuted on Wednesday, encouraging Coloradans to end the stigma around mental health care by talking openly about their stories.

Nearly 10% of the state reported eating less than they should because they did not have enough money for food, with people aged 19 to 49 the most likely to go hungry. That age range was also the most likely to report experiencing unfair treatment when getting medical care.

The survey noted that 85% of Coloradans described their health as good, very good, or excellent, and people with higher incomes generally reported better health.