Mapping the Eligible and Uninsured – Who They Are and Where They Live

Tamara Keeney

May 9, 2014
Health Coverage and the Uninsured

The next open enrollment period for private insurance doesn’t begin until November, but planning has already begun in Colorado for outreach and enrollment efforts next time around.

And as state and private organizations develop their strategies, many are asking these questions: What are the demographic characteristics of Coloradans who are eligible for new coverage under the Affordable Care Act (ACA)? Where do they live?

To help answer these questions, the Colorado Health Institute is issuing our first map-based study based on our analysis of the latest data. “The Colorado Eligibility Atlas: Mapping the Uninsured,” is a series of 17 maps created from our estimates.

We set out to answer this question by looking at two populations:

  • Children and adults who are eligible for but not enrolled (EBNE) in Medicaid or Child Health Plan Plus (CHP+)
  • Children and adults who qualify for tax credits (QTC) when purchasing private health insurance through the state’s marketplace,  Connect for Health Colorado.

We wanted to know how many uninsured and eligible Coloradans there are, but we also wanted to know who they are – where they live, their demographic characteristics and their reasons for being uninsured.

Many Coloradans have become eligible for coverage under the ACA. Colorado chose to expand Medicaid eligibility to all adults with incomes at or below 138 percent of the Federal Poverty Level (FPL). Colorado also opted to create a state-based private marketplace where Coloradans with family incomes between 138 percent and 400 percent of the FPL can qualify for federal tax credits to assist with the cost of health insurance premiums.

The latest available data is from 2012 and 2013 – the 2012 American Community Survey, 2012 Medicaid and CHP+ caseload counts from the Colorado Department of Health Care Policy and Financing, and the 2013 Colorado Health Access Survey data. We used these data to develop estimates for the Coloradans who could be affected by the policy changes that began in January.

Some high level findings:

  • One of five uninsured adults who are eligible for Medicaid (20.5 percent) are unemployed and looking for work, compared to 5.8 percent of all Colorado adults.
  • The two groups of uninsured Coloradans – both those who are eligible for public insurance (Medicaid and CHP+) as well as those who qualify for tax credits – are more likely to speak Spanish at home compared to all Coloradans.
  • Three areas of the state, in particular, stand out:
    • Northwest Colorado and the mountain resort communities have above average percentages of eligible but unenrolled Coloradans who speak Spanish at home.
    • Denver and the Front Range urban areas are home to the highest numbers of uninsured Coloradans who are eligible for public insurance or a tax credit.
    • The Eastern Plains has high proportions of uninsured but eligible adults who are unemployed and looking for work.
  • Nearly one of four (24.6 percent) uninsured Coloradans at or below four times the poverty level report that they don’t believe they need health insurance.

The report contains data that can be useful in developing targeted outreach and enrollment strategies. Research reviewed by the Colorado Health Institute shows that the most successful strategies tailor strategies to different demographics, such as age, Spanish language speakers, employment and education.

The Atlas, data workbook and methods document are available for download here.