A confusing and lengthy enrollment process for Medicaid and CHP+ results in many
   Coloradans who are eligible for coverage going without health care.

   Trust grant strategies include:
      » Simplify and streamline eligibility and enrollment processes
         for public insurance programs
      » Develop and implement systems and policies to support
         continuous enrollment
      » Strengthen and expand effective community outreach
         and enrollment programs

Increase Outreach and Enrollment Background and strategies - The Colorado Trust

Expanding coverage to make affordable, quality options available to all Coloradans will be a significant achievement. However, ensuring that all Coloradans are successfully enrolled in these expanded coverage options by 2018 will require simultaneous investments to make outreach and enrollment processes more effective. The difficulty Colorado has had with enrolling and retaining currently eligible children into existing free and low-cost insurance options is illustrative of the challenge ahead.

As shown in the figure below, most Coloradans who currently lack health coverage are not eligible for existing public programs because their income is too high to qualify. However, approximately 11% of the uninsured, mostly children, are eligible for Medicaid or Child Health Plan Plus (CHP+) and successfully connecting them to these existing coverage programs would reduce the number of uninsured children by more than 80,000. 

Average monthly uninsured by Medicaid eligibility status. Source: Adapted from

The pathway to eligibility, enrollment and renewal in Colorado's Medicaid and CHP+ programs is complex and fraught with opportunities for confusion, error or other system failures that result in a lack of consistent coverage for low-income children. Outreach efforts are necessary to educate parents about eligibility, help families to enroll, and provide application assistance to families who need help navigating a difficult and paper-intensive system. Simultaneous efforts need to tackle arcane policy and inflexible computer systems in order to simplify and streamline the processes for eligibility, enrollment and renewal, and to develop better methods for monitoring the entire enrollment process.

Given Colorado's complicated and constantly changing system of public coverage, a persistent outreach and enrollment gap exists. This gap means that children and adults who are eligible for health coverage may not receive the preventive care, treatment for chronic or acute conditions and health outcomes to which they are entitled.

While application assistance sites and other formal mechanisms exist to help families navigate the Medicaid and CHP+ eligibility process, it remains a challenging undertaking with multiple barriers. Families attempting to sign up for care for the first time may not be familiar with public programs or may be frustrated by a confusing and lengthy enrollment process. Others within low-income communities have a long history of mistrust of the system. Additionally, approximately half of the uninsured children in Denver who are eligible but not enrolled in public programs have parents who are not U.S. citizens. Recently immigrated parents face additional barriers to enrolling their citizen children in coverage, including language difficulties, and for undocumented parents, fear of detection and mistrust of government.


 Connecting children to Medicaid or CH+ would reduce the number of uninsured children in Colorado by more than 80,000. Increase outreach and enrollment - The Colorado TrustColorado's complicated public health care coverage system makes it tough for families ot navigate the enrollment process. Increase outreach and enrollment - The Colorado Trust