In 2009, the economic crisis and apparent loss of momentum for health reform seemed to reduce the likelihood of expanding health coverage. Indeed, as Colorado's unemployment rate reached 8.3% – its highest rate in 26 years – many more people lost their health coverage along with their job. The employed also struggled as private insurance premium growth increasingly forced workers to opt out of employer-based coverage.

Against this difficult backdrop, a promising step was taken to cover more uninsured Coloradans. The Colorado Trust provided support to the Office of the Governor to research the potential benefits of a hospital provider fee to extend coverage to more Coloradans and reduce the number of uninsured. The findings from this research resulted in the development and passage of HB09-1293, the Colorado Healthcare Affordability Act. It is estimated that this policy will bring in an additional $1.2 billion annually – $600 million from a fee paid by Colorado hospitals and $600 million for a federal match – to cover 100,000 of Colorado's 800,000 uninsured. Several additional Trust-supported research studies conducted in 2009 also provided important information for state decisionmakers:

• The Colorado Household Survey gathered information from 10,000 Colorado households about health insurance coverage, employment status, access to and utilization of health care services. This extraordinary data set is being used by the Colorado Department of Health Care Policy and Financing, the Colorado Health Institute and others to provide an accurate assessment of the many issues surrounding health coverage and access to care in Colorado.
• The Future of Colorado Health Care, is a study jointly commissioned by The Colorado Trust and the Colorado Health Foundation, and undertaken by New America Foundation and the University of Denver's Center for Colorado's Economic Future. The study considers the economic consequences of doing nothing to change our health care system and, conversely, the impact health reform would have on Colorado's economy. The study shows, for example, that employer health care contributions would rise by 109% over the coming decade in the event of no changes to our health care system.
• The Cost of Care: Can Coloradans Afford Health Care? This study was conducted by the Colorado Center on Law & Policy and Colorado Voices for Coverage to address the fundamental question of what affordable health care means for Colorado families. The findings show that when low-income Coloradans spend more than 5% of their household income on health care, they make substantial tradeoffs on other important expenditures, such as transportation, housing, child care and education.

Additionally, The Trust supported multiple advocacy and communication efforts to increase awareness and improve understanding about expanded health coverage.

LOOKING AHEAD, The Colorado Trust is supporting strategies to:

• Build awareness, understanding and support among key stakeholders about the benefits and cost of expanded coverage
• Develop policy options for coverage expansion and financing
• Sustain coverage expansion gains made in Colorado
• Implement expanded coverage as a result of federal health reform.

See a list of all grantees receiving support from The Colorado Trust to Expand Health Coverage.