Colorado Department of Health
Care Policy and Financing
Fulfilling the Promise of Coverage
October 8, 2010
Colorado Department of Health Care
Policy and Financing
Focus on Systems
Improvements/State Expansions
1. What is real opportunity to fulfill the promise of
coverage through systems improvements and state
expansions?
2. Where do we have momentum that needs to be
maintained or built upon?
3. What is going to be hard or require concerted effort to
ensure our success in Colorado?
4. What is the most important thing advocates and
community partners can do to ensure we fulfill the
promise of coverage?
Colorado Department of Health Care
Policy and Financing
Health Care Affordability Act (09-1293):
Expansion of Coverage
• May 2010: Implemented Medicaid eligibility for parents
up to 100% of the FPL (24,193 Aug 2010)
• May 2010: Implemented CHP+ eligibility for children
and pregnant women up to 250% of the FPL (2,018
children and 71 pregnant women Aug 2010)
• Summer 2011: Implement Medicaid Buy-In program for
people with disabilities up to 450% of FPL
• Early 2012: Provide health care benefits for adults
without dependent children up to 100% of FPL
• Spring 2012: Implement twelve-month continuous
Colorado Department of Health Care
Policy and Financing
Colorado Health Insurance Status
Pre and Post Health Care Reform
Current (US Census - ACS)
22.40%
Projected (2014)
5%
15.80%
25%
No health insurance
coverage
No health insurance
coverage
With private health
insurance coverage
With private health
insurance coverage
With public health
coverage
With public health coverage
70%
71.30%
• 778,000 Currently Uninsured
•300,000 Obtain Insurance Exchange
(Estimated)
•200,000 – 250,000 Medicaid (Estimated)
•250,000 Uninsured (Estimated)
Colorado Department of Health Care
Policy and Financing
The Maze
Colorado Department of Health Care
Policy and Financing
Eligibility Modernization Project
• Initiated in 2008
• Implement strategies that will make the
application process easier for individuals
and families
• Three focus areas
– Systems/Technology
– Policy Changes
– Business Processes
Colorado Department of Health Care
Policy and Financing
Mobile Web Survey
• Adult laptop and cell phone internet (mobile Web)
use
– 2009 51%
– 2010 59%
• African-Americans active use of mobile web
– 2009 57%
– 2010 64%
• African-Americans & English speaking Latinos
ownership of cell phones v. whites (2010)
– 87% - 80%
• States’ efforts lagging behind
– ½ states have online enrollment for CHIP
– Less than that for Medicaid
– On average, 30% of new enrollments generated online
Source: Pew Internet and American Life Project, July 2010 http://pewinternet.org
Colorado Department of Health Care
Policy and Financing
Accomplishments
• Implemented online self-screening tool (Am I Eligible? and Check
My Benefits) PEAK: October 2009
• Application Overflow Process (April 2009)
• Leveraged our Community-Based Organization infrastructure (PE
Sites, Medical Assistance Sites, Certified Application Assistance Sites)
• Legislation permitting telephonic renewal, ex-parte redeterminations
• Received HRSA State Health Access Program grant to fund outreach
and eligibility modernization efforts
• New health application
• Eligibility and Enrollment for Medical Assistance Programs
(EEMAP) RFP completed and contract signed with Maximus
• MORE grants ($628,790) made available to 14 community
organizations
• Regional outreach and training conferences held
• Colorado Eligibility Process Improvement Collaborative (CEPIC)
Colorado Department of Health Care
Policy and Financing
Coming Attractions/Momentum
• November 2010: Begin Vital Statistics Pilot
• January 2011: Phase II of PEAK (Am I Eligible? And
Report My Changes)
• 2011 – PEAK Outreach Toolkit Available
• Interfaces – DRA Citizenship and Identity Requirements
–
–
–
–
Vital Statistics
Income and Eligibility Verification System (IEVS)
Department of Revenue, Department of Motor Vehicles
Social Security Administration
• Express Lane Eligibility
• Free and Reduce Lunch
• Income Tax Records
Colorado Department of Health Care
Policy and Financing
Challenges/Opportunities
• Budget
• Transition to a new administration
• CBMS: competing priorities/capacity to implement new
changes
• Health care reform implementation: 2014 is closer than
we think
• Transition to a new eligibility and enrollment vendor
• Securing Year 3 funding for the HRSA SHAP grant
• State/county partnership
Colorado Department of Health Care
Policy and Financing
Fulfilling the Promise
• Urge continuation of existing policies in the next
administration
• Continued participation as Certified Application sites,
Presumptive Eligibility and Medical Assistance sites
• Secure year three funding for the HRSA SHAP grant
• Continue to be passionate as we work together to ensure
coverage for all Colorodans
Colorado Department of Health Care
Policy and Financing
Sue Williamson
Executive Deputy Director
Colorado Department of Health Care Policy and Financing
Susan.Williamson@state.co.us
303.866.2618