Trump's policy threatens Colorado's child health coverage

Impact of New Federal Guidance on Colorado’s Children’s Health Coverage

The recent changes in federal policy have significantly affected Colorado’s efforts to provide continuous health coverage for young children. This shift has raised concerns among advocates and experts, as it could lead to a loss of essential health services for thousands of low-income families.

Colorado had planned to implement its continuous coverage initiative starting January 1, 2026. The program aimed to ensure that babies and toddlers enrolled in public health insurance programs, such as Medicaid or the Child Health Plan Plus (CHP+), would remain covered until they turned three. However, new guidance from the Trump administration has disrupted these plans.

Under the new rules, parents will now need to reconfirm their eligibility every 12 months instead of being automatically enrolled. If they fail to meet the deadlines or their income slightly exceeds the threshold, their children may lose coverage. This change is particularly concerning because it could result in missed medical appointments and delayed interventions for developmental issues.

During the pandemic, the federal government allowed continuous enrollment without annual paperwork for those on public insurance programs. As the pandemic ended, some states, including Colorado, sought to extend this policy for vulnerable populations. The Trump administration's new guidance marks a departure from this approach, emphasizing "fiscal and program integrity" as the rationale for ending continuous eligibility for certain groups.

This decision comes amid broader efforts to reduce funding for various safety net programs. The recent budget bill signed by Trump includes deep cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP). U.S. Senator Michael Bennet, a Democrat running for Colorado governor, has criticized these cuts and introduced a federal bill to ensure continuous public health coverage for children until they turn six.

Bennet highlighted the importance of consistent coverage during a child's critical development stage, especially as the Republican-led policies may increase barriers to access and lead to more people losing their health care. CHIP, the federal and state health insurance program for children not eligible for Medicaid, is also impacted by these changes.

With Republicans controlling Congress and the White House, Bennet’s proposal faces significant challenges. Madi Ashour, director of K-12 education policy for the Colorado Children’s Campaign, emphasized the potential consequences of the federal restrictions. She noted that missing out on regular doctor visits could prevent early detection of developmental issues, leading to long-term problems.

Ashour explained that Colorado’s continuous coverage initiative can be viewed as a way to reduce the workload for kindergarten and elementary teachers. Children who start school with undiagnosed developmental delays are more likely to face difficulties with literacy, behavior, and social interactions, which could require costly interventions later.

A 2023 Colorado law set the stage for the state’s plan to provide continuous public health insurance coverage for two groups: young children during the first 36 months of their lives and adults within the first 12 months after release from state prison. The state received approval from the Biden administration to launch the initiative in 2026, but this approval needed renewal by the Trump administration in December. It now seems unlikely that this will happen.

Marc Williams, a spokesperson for the Colorado Department of Health Care Policy and Financing, stated that plans for the January 1 launch are being reconsidered. The department is analyzing whether it needs to revise legislation and assess the fiscal impact of these changes.

Ann Schimke, a senior reporter at WHY NOT, covers early childhood issues and early literacy. She can be contacted at aschimke@WHYNOT.org.