Access to healthcare in Colorado: A new day, but there’s still work to be done

Colorado Uninsured Rate Down 53%

Every other year since 2009, the Colorado Health Access survey has been conducted by interviewing at least 10,000 Colorado households on a variety of health-related metrics.  The 2015 report was released on September 1, and is aptly titled “A New Day in Colorado.”  One of the biggest headline grabbers in the latest report is the Colorado uninsured rate.  In 2013, the Colorado Health Access survey found that 14.3% of Colorado residents were without health insurance.  This year, it’s less than half that amount, with just 6.7% of our state’s population remaining uninsured.  That’s roughly 362,000 people – down from more than 706,000 two years ago, despite the fact that Colorado’s population has grown by almost 130,000 people in the last two years.

Interestingly enough, although much is said about “young invincibles,” the population most likely to be uninsured in Colorado are thirty-somethings.Colorado uninsured rate  13.4% of people age 30 – 39 are uninsured, while 12.9% of 19 – 29 year-olds are without coverage.  In 2011 and 2009, young adults age 19 – 29 had the highest uninsured rate, but it’s likely that the ACA provision to allow young adults to remain on their parents’ health insurance until they reached age 26 has helped to reduce the uninsured rate among people younger than 26.

It’s worth noting that Gallup data still shows a double-digit uninsured rate in Colorado, and a higher starting point in 2013.  According to Gallup, 17% of Colorado residents were uninsured in 2013, and by mid-2015, the uninsured rate had dropped to 10.6.  But Gallup’s data relied on a far smaller sample size (1,767 in the first half of 2015, versus 10,136 for the Colorado Health Access survey).

But how accessible is healthcare?

Although the unisured rate has dropped considerably, the survey is all about access to care, which depends on more than just having health insurance.  One must also be able to use that coverage, including being able to pay the associated out-of-pocket costs.  The survey found that 16.4% of respondents are “underinsured,” which means that they are unable to afford care, despite having health insurance.  The term is defined as having out-of-pocket costs that are more than 10% of household income (5% for people with incomes under 200% of the federal poverty level).  Unfortunately, although far fewer Colorado residents are uninsured, the underinsured rate climbed since 2013, when the survey data put it at 13.9%.

And in terms of actual affordability of care, more than one in ten survey respondents in 2015 said that they had avoided seeing a doctor because of the cost, and nearly one in ten had skipped filling a prescription because of the cost.  These numbers are down slightly from 2013, but nowhere near as much as the overall uninsured rate.

Undocumented immigrants

Incidentally, it’s virtually impossible under current laws to reach a zero percent uninsured rate.  According to Kaiser Family Foundation data, about 81,000 uninsured Colorado residents were undocumented immigrants in 2013, and thus ineligible for marketplace coverage or Medicaid (KFF’s data put the total uninsured population at 737,000 in 2013)  But the Colorado Alliance for Immigration Reform pegged the total number of undocumented immigrants at 180,000 in 2012, and it’s unlikely that many of them had health insurance in place at that point.

Depending on which number we use, Colorado has reached the point where between a quarter and a half of the remaining uninsured population is comprised of undocumented immigrants.  That’s a population that’s understandably tough to insure, although California lawmakers are considering a bill (SB4) that would allow undocumented immigrants to purchase coverage (without subsidies) through the exchange in California.  Other states are no doubt watching its progress – the CA senate passed the bill in June, and it’s currently with the Assembly.

About Louise Norris

Louise Norris has been writing about health insurance and healthcare reform since 2006. In addition to the Colorado Health Insurance Insider, she also writes for healthinsurance.org, medicareresources.org, Verywell, Spark by ADP, and Boost by ADP, and Gusto. Follow on twitter and facebook.

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