With the federal government’s COVID-19 public health emergency set to end in May, an estimated 325,000 Coloradans face losing Medicaid coverage.

To put that number into perspective, Colorado enrolled 400,000 people in the first two years of the state’s Medicaid expansion in 2014.

“The magnitude of transitioning that number of people hasn’t been seen since the Affordable Care Act,” said Marc Williams, spokesperson for the Colorado Department of Health Care Policy and Financing (CDHCPF).

The Affordable Care Act — the landmark law pushed by then-President Barack Obama — allowed millions of Americans to access healthcare through tax subsidies and a major expansion of income eligibility to enroll in Medicaid in one of the largest movements of uninsured to insured in the country’s modern history.            

Williams added: “Our primary goal this year is to ensure people have continuity of care.”

Most will lose eligibility because their income exceeds Medicaid’s limit.

The disenrollment, which will occur over several months, is not unexpected. Ensuring that Coloradans — and other Medicaid recipients across the country — kept their health coverage was meant to be a temporary response to the COVID-19 pandemic, which compelled governments to shut down businesses in its earliest stage and left millions without jobs. 

Colorado has since fully recovered from the pandemic-induced job losses. Indeed, Gov. Jared Polis recently there are now “two available jobs for every unemployed person” in Colorado, a factual claim.  

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

According to the U.S. Department of Health and Human Services, about 15 million Americans could be disenrolled from Medicaid, including 6.8 million who will lose coverage despite being eligible.

Williams said the department does not yet have a “granular breakdown” of who in Colorado will lose their Medicaid coverage.

The actual number of Coloradans removed from the Medicaid rolls may not be known until next summer.

Children, young adults and racial minorities, though, are expected to be disproportionately affected.

Roughly 5.3 million children nationally and 4.7 million adults ages 18 to 34 are anticipated to lose coverage, according to the federal government. And nearly a third of the disenrolled nationally are predicted to be Latino, while 15% will be Black.

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 under the Families First Coronavirus Response Act, which Congress approved at the start of the pandemic.  

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. 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.

“They won’t lose their coverage all at once,” Williams said.

Last month, the Biden administration announced the public health emergency will end May 11.

The emergency designation is most frequently associated with the restrictions implemented to curb the spread of the virus. Nearly all the federal and state rules intended to slow transmission of the virus have already gone away, such as masking and testing requirements.

The move to end the national emergency marks the federal government shifting its response by allowing the states to more fully manage the public health threat. The end of continuous Medicaid enrollment also means phasing down the enhanced federal Medicaid matching funds the states received. The wind down period is expected to last through December of this year.

Colorado will begin reviewing Medicaid eligibility in May. Beneficiaries are encouraged to update their contact information at co.gov/peak.