Congress is once again considering major changes to the Affordable Care Act which has expanded coverage and resulted in improved health outcomes for our entire state over the last five years. The new proposed American Health Care Act (AHCA) is a bill that would cut critical funding to Colorado’s Medicaid program, as well as put at risk major gains in coverage and quality. While cuts to Medicaid would affect the entire state, Colorado’s rural communities would be hit particularly hard.
Despite a statewide economy that is growing, people in many of Colorado’s rural communities continue to struggle to make ends meet. The average annual wage in Eastern and Southern Colorado is just $35,000 per year, $20,000 below the state average. Rural counties like Huerfano, Conejos, and Rio Blanco have unemployment rates nearly double the state average.
The financial struggles of so many rural Coloradans make Medicaid even more important in these communities. Medicaid provides many hard working people in Colorado with the health coverage and care they need. According to the Colorado Health Institute, over 185,000 rural Coloradans, rely on Medicaid. Medicaid covers more than 40 percent of many rural county’s residents, including Otero, Prowers, Huerfano, Conejos, Costilla, Rio Grande, Saguache, Alamosa and Pueblo. In many other counties upwards of 30 percent are covered by Medicaid. Since Colorado expanded Medicaid, we’ve cut the rate of uninsured in rural counties by half, and 90 percent of rural Coloradans now have health coverage. Colorado’s Medicaid program is keeping costs down while improving the quality of health care.
The Medicaid program spends less than 4 percent on administration and has kept its per capita costs flat since 2012. Coloradans who participate in Medicaid’s Accountable Care Collaborative program for longer periods of time are less likely to visit the emergency room and are more likely to receive important preventive care, like well-child visits. Since 2011, the Accountable Care Collaborative has saved Colorado taxpayers more than $140 million, and emergency room usage is down 6 percent and prenatal care is up 23.6 percent.
Expanding Medicaid has boosted Colorado’s economy. When more Coloradans are insured, hospitals and other providers don’t need to raise their prices to cover the cost of uncompensated care. Insurers can offer lower insurance prices and this benefits businesses by lowering their health care costs. According to the Colorado Health Foundation, because of the Medicaid expansion, household earnings are up more than $600 per year and Colorado has added 31,000 job.
But the AHCA threatens to take Colorado backward and hurt rural Colorado. The bill would cut federal funding for Colorado’s Medicaid program by almost $1 billion a year by dramatically reducing federal funding for the Medicaid expansion. There is simply no way for the state to afford to make up that deficit on its own. In analyzing a similar proposal, we have concluded that the state would be forced to make substantial cuts to eligibility, benefits, and payments to providers. The more than 57,000 rural Coloradans who rely on Colorado’s Medicaid expansion would be at risk of losing their coverage and living less healthy lives.
The current system built on the Affordable Care Act is imperfect and can be improved, but putting rural Coloradans and their communities at risk is the wrong approach.
Donna Lynne is Colorado’s Lieutenant Governor and a former vice president with Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals.
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