More than 200,000 Colorado children are expected to lose their health insurance once the federal government’s COVID-19 public health emergency ends.

On Monday, U.S. Senator Michael Bennet and 14 of other Democrats urged the Centers for Medicare & Medicaid Services (CMS) to ensure the gains in reducing the number of uninsured children is not lost when the agency winds down policies enacted to keep people continuously enrolled during the public health emergency.

Anyone enrolled in Health First Colorado – the state’s Medicaid program – was guaranteed health coverage because states were required to keep people continuously enrolled during the public health emergency.

The emergency declaration is set to end on May 11.

In December, Congress passed a bipartisan funding bill that requires states to keep kids enrolled in continuous coverage for 12 months at a time. The new requirement, however, does not kick in until January 1, 2024.

Children often lose coverage not because they are ineligible, but because parents pick up an extra shift temporarily boosting their pay and making them ineligible, or they miss a deadline, causing what’s called “churn” in the system. 

“Churning in and out of health coverage has a direct, negative effect on children who rely on Medicaid and CHIP, as well as the ability of doctors, hospitals, and health plans to provide effective, continuous care,” the senators wrote CMS Administrator Chiquita Brooks-LaSure on Feb. 21.

As a result of the federal government’s continuous enrollment provision and additional Affordable Care Act subsidies over the past two years, uninsured rates dropped 2.7% for adults and children, the senators wrote.

Bennet and his colleagues urged CMS to make continuous health care coverage for children enrolled in Medicaid and CHIP a national policy.

All told, an estimated 325,000 Coloradans – 220,000 of whom are children – are expected to be disenrolled from Medicaid. That number rivals the 400,000 people enrolled in the first two years of the state’s Medicaid expansion in 2014.

Estimated 325,000 Coloradans will lose Medicaid with end of COVID-19 public health emergency

The Colorado Department of Health Care Policy and Financing administers the state’s Medicaid program, the federal safety net which provides health coverage to low-income people.

Medicaid in Colorado provides health care for roughly one in four residents.

To be eligible for Medicaid, the annual household income before taxes for a single person must be below $18,075 and $36,908 for a family of four.

Most of those expected to lose eligibility will be because their income exceeds Medicaid’s limit.

The state is expected to take 12 to 14 months to review Medicaid eligibility for the roughly 1.7 million Coloradans enrolled in the program. The Colorado review is set to begin in May.

Case reviews will be based on an individual’s enrollment anniversary. So, for example, someone who enrolled in April will not be reviewed until next year.

The emergency designation is often associated with the restrictions implemented to curb the spread of the virus. Nearly all these federal and state rules, however, have already gone away.

The move to end the national emergency marks the government’s shifting response to an endemic public health threat managed through agencies regular authority.

Click here, to read the full letter.