Behind the Numbers: Medicaid Eligibility

A Colorado yoga instructor faces life without Medicaid.

May 8, 2024

Kristen had been navigating life on Medicaid for a couple of years after moving off her mom's coverage in her mid-20s. It was a safety net she'd grown accustomed to until a bittersweet twist took her off the program. 

Kristen, a yoga instructor, meditates in a nature setting with a rainbow behind her.
The joy of a pay raise was dampened by the loss of Medicaid eligibility for Kristen, a 28-year-old yoga instructor and freelance marketer.

"I got a raise," she said.

The pay bump put her above the maximum to qualify for Medicaid, which is 138% of the federal poverty level for adults without children.

"Suddenly, I was without coverage. Just like that, at the end of December,” she said.

The 28-year-old yoga instructor and freelance marketer was on her own. A month passed, and Kristen found herself grappling with a severe cold that settled into her lungs, causing pain. Her parents helped cover the costs of clinic visits. But the fear of needing more extensive treatment or additional consultations loomed over her.

"It was terrifying," she said. "I knew I needed help, but the cost of health insurance was overwhelming."

From 2020 through early 2023, a pandemic emergency rule kept all Medicaid members enrolled, no matter their income. But that policy had expired by the time Kristen got her pay raise.

Now, she’s one of thousands of Coloradans who have lost Medicaid eligibility. Her story illustrates why the Colorado Health Access Survey’s coverage data is likely out of date already. Between May and December 2023 Colorado Medicaid enrollment dropped by more than 300,000 people. Those people have either found other coverage or are uninsured.

Kristen wanted to be covered. She started shopping for health insurance — something she had never done before. She scoured through options, astonished by the costs, even with tax credits available through the Affordable Care Act.

"The numbers were staggering," she said. "I couldn't afford the kind of coverage I needed, let alone at $800 a month for medium-sized coverage." 

Kristen wondered how she would afford rent and health insurance every month. 

She found a broker online, and an agent guided her through the labyrinth of insurance options.

"After much searching and contemplating, I found this plan," Kristen said. "It's a bare minimum plan, with a price tag of $298 a month. It's not much, but it's something. It even includes dental coverage, though I'm unsure about its extent."

Kristen's story highlights the challenges many face when caught between the safety net of Medicaid and the daunting cost of private insurance. Like her, many Coloradans struggle to maintain basic health care access in a system fraught with complexities and costs.

"It's a chunk of change for me," she admitted. "But at least now, I have some coverage, some assurance that I won't be entirely at the mercy of medical bills."

"I couldn't afford the kind of coverage I needed, let alone at $800 a month for medium-sized coverage."