Report highlights impact GOP health care plan would have on kids in rural Colorado

Author: Peter Marcus - June 7, 2017 - Updated: June 7, 2017

(Jerilee Bennett, The Gazette)


In arguing against a rollback of Medicaid expansion, the Colorado Children’s Campaign on Wednesday pointed to a recent study that shows that kids in rural communities would be impacted.

The report, released by the Georgetown University Center for Children and Families and the Rural Health Research Project of the University of North Carolina, found that a larger share of children in small towns and rural areas of Colorado rely on Medicaid than those that live in urban areas.

According to the report, 42 percent of children in rural areas and small towns in Colorado receive health coverage through Medicaid, compared to 35 percent in Colorado’s urban areas. For adults, 20 percent in non-metro areas are covered by Medicaid compared to 15 percent in urban areas.

“When kids and families have health insurance, the entire community is strengthened,” said Sarah Barnes, senior policy analyst for the Colorado Children’s Campaign. “More access to care can mean fewer visits to the ER, less uncompensated care and more people getting – and staying – healthy. If Medicaid is cut, it will undermine the financial stability of rural hospitals and health care clinics that whole communities rely on for care.”

The organization targets the American Health Care Act, which was recently passed by the Republican-controlled U.S. House. The measure would curb Medicaid expansion and cap the program.

A new report released by the Institute for Child, Youth and Family Policy at Brandeis University estimates that nearly 5 million children across the nation, including almost 71,531 in Colorado, may no longer be eligible for Medicaid if the GOP’s plan to repeal the Affordable Care Act is approved.

Under the proposed ACA repeal plan, the number of school-age children in Colorado federally eligible for Medicaid would decrease by 7.8 percent, according to the report.

The Republican effort targets the Affordable Care Act, passed under President Obama. The law allowed states to expand eligibility for Medicaid, with the federal government picking up most of the cost. Nationally, about 10 million people expanded into the program.

Colorado saw an expansion of about 407,000 through the 2015-2016 fiscal year, or about 7.5 percent of the state population, according to the Colorado Health Institute. The Affordable Care Act also helped bring in people that would have qualified for the program pre-ACA, but who were unaware before the publicity of the program.

Under the Republican American Health Care Act, Medicaid expansion would gradually roll back starting in 2019. Federal reimbursements to states would be cut. Instead, the federal government would give states a capped amount of money for each Medicaid enrollee, or let states choose to receive a block grant.

The legislation would cut Medicaid spending by about $880 billion, according to the Congressional Budget Office.

Republicans support the legislation to repeal the ACA by pointing to problems under Obamacare, in which health insurance costs skyrocketed, especially in rural areas. Low-income individuals who do not qualify for Medicaid have found it difficult to obtain affordable health care. The GOP also says spending is out of control, and that the country cannot sustain an expanded benefits program.

“Medicaid is a vital safety net program that was stretched to a near breaking point by an unwise expansion effort caused by Obamacare,” said Jarred Rego, spokesman for U.S. Rep. Doug Lamborn, R-Colorado Springs. “Congressman Lamborn would like to see it be a program that is solvent and available in the long-term for rural children and those among us who need the most help. This is what will be accomplished by returning Medicaid flexibility to the states.”

But in Colorado, the uninsured rate for adults in rural areas dropped from 28 percent to 17 percent between the 2008-2009 fiscal year and the 2014-2015 fiscal year. The uninsured rate for rural children dropped from 15 percent to 7 percent during that same time, according to the Colorado Children’s Campaign.

Of the Republican repeal-and-replace plan, the organization says, “These changes would shift costs to Colorado and have a devastating impact on the state budget.

“It would dismantle Medicaid’s flexible financing structure that has protected children, families, individuals with disabilities and seniors during economic downturns or when Colorado faced increased health care costs due to natural disasters like floods and wildfires. Based on the data in this new report, the House bill would have an even larger impact on children and families living in rural areas and small towns across the state.”

Peter Marcus

Peter Marcus

Peter Marcus is senior statehouse reporter for Colorado Politics. He covers the legislature and previously covered politics, the governor’s office, the legislature and Congress for The Durango Herald. He joined The Herald in 2014 from The Colorado Statesman, a Denver-based political weekly. The Washington Post twice named Marcus one of the nation’s top state-based political and legislative reporters.