Colorado's uninsured rate for children rose in 2024 as the COVID-19 public health emergency ended and kids dropped off Medicaid.
About 6% of people under 19 didn't have some form of health insurance in 2024, according to new data from the U.S. Census Bureau. A year earlier, about 4.1% were uninsured.
The uninsured rate also increased for adults under 65 in Colorado, from 9.2% to 10.5%.
Nationwide, 6% of children and 11.3% of working-age adults didn't have insurance in 2024.
The Medicaid "unwinding" at the end of the COVID-19 public health emergency was the biggest reason why children's uninsured rates went up, said Joan Alker, executive director of the Center for Children and Families at Georgetown University, who analyzed the census data.
The share of kids without coverage increased in 19 states, dropped in one and stayed level in the rest.
Early in the pandemic, the federal government gave states financial incentives to stop removing people from their Medicaid rolls. In spring 2023, Congress ended that provision, requiring states to redetermine who should qualify over the next year. About 550,000 people in Colorado lost coverage during that year, though some later regained it.
The number of children covered by Medicaid in Colorado dropped from about 608,000 in May 2023 to 420,000 in May 2024, before rebounding slightly.
For most of the last decade, the uninsured rate for kids has dropped as more families enrolled in Medicaid and Child Health Plan Plus, said Toni Sarge, director of health policy at the Colorado Children's Campaign. Typically, the state's rate was below the national average, but, in 2024, they were neck-and-neck.
Colorado had policies meant to keep kids and adults covered during the Medicaid unwinding, but the state wasn't as successful in doing so as other blue states, Alker said. With some exceptions, blue states put more focus on automating renewals to make it easier to stay covered, while red states generally weren't as concerned about their residents losing Medicaid, she said.
State officials did what they could, but ran into bumps along the way, such as when adults trying to renew their coverage couldn't upload photos of their driver's licenses as required, Sarge said. With limited funding available to make the administration run smoothly, people lost coverage because of technological or human errors, she said.
"We have a state that really prioritizes health insurance... but has trouble funding it," she said.
This year, the uninsured rate should stabilize, since the unwinding is over and Medicaid work requirements in H.R. 1, known as the "Big Beautiful Bill," aren't yet in place, Sarge said. But she's worried about the "short runway" to set up new systems by the start of 2027, because Colorado has never had the infrastructure to require people to prove they worked 80 hours a month.
"Colorado is going to struggle to maintain our rate of coverage," she said.
Nationwide, the uninsured rate for children likely will continue to rise as families with some undocumented members hesitate to sign up their American-born children in Medicaid, Alker said. In addition, parents who are confused by the new work requirements may give up trying to enroll their families, even if at least some members still qualify, she said.
"Eligible children will lose coverage too, even when they shouldn't," she said.