DENVER — A bill passed in Colorado's state legislature this year directs the state to complete a feasibility study that explores seeking federal authorization for nutrition and housing support through Medicaid.
Individuals must be eligible to receive that kind of support through Medicaid. Currently, the proposal lists three groups of people who the expansion would apply to: Those who are unhoused or at risk of losing their home, individuals leaving a nursing home with nowhere to go, and people transitioning out of foster care.
“It is meant for the most vulnerable folks on our state Medicaid program," said one of the sponsors of House Bill 24-1322, State Representative Kyle Brown, a Democrat who represents Boulder and Broomfield counties. “This is a great opportunity for the State of Colorado to, without spending any more state taxpayer dollars, to leverage existing resources at the federal level to better serve our community.”
Colorado is one of a number of states pushing for additional support through Medicaid.
“It's a Biden-era policy, that the Centers for Medicare & Medicaid Services changed their policy a couple of years ago to allow for these types of programs," Brown said. “We know that we are in a crisis of folks who are unhoused. We know that people who have chronic conditions often struggle to have healthy food at home, and this bill will help to make sure that we are providing additional resources and hopefully improving the quality of life and lowering everyone's costs.”
Out of more than a million Coloradans on Medicaid, it's estimated the expansion would cover around 11,000 people.
“This allows us to bring in tens of millions of dollars in federal match to help build out those programs that we've already started here in our state," said the Deputy Medicaid Director for Colorado, Cristen Bates. “What kind of services can we provide that are allowed? Who can access those services? How much does do those services cost? And also, very importantly, how much do we save by covering these people and keeping them well, instead of paying for very expensive emergency room visits? Paying for them to be involved in criminal justice systems? When we keep people healthy and housed, it really has a lot of benefits to not just the individual, but to the family and to the community.”
Bates said the Department of Health Care Policy & Financing is going through a phased approach, and has already began implementing some programs that are similar to the nutrition and housing assistance they want to expand.
“Some of the other elements around broader populations or more nutrition support, it's going to take more time. And so, we didn't want to hold back any programs we could start now," said Bates. “Colorado's General Assembly has said, if you can go and help people, we'd like you to go ahead and start. So we've already started. We have started. We've already identified a $50 million plan to help cover six months of rent, cover nutrition services, cover wrap around services help people move in, help people get housing... What we're going to study is, what else can we do? So we're going to keep asking the federal government for their approval, and every time we do that, we're going to work with our state legislature. Because Medicaid is a state federal partnership, we have to have both sides in alignment anytime we change our policies... What's exciting about this work, to me, is that we get to expand on programs that have already been prioritized by our communities, and it really is about using those federal dollars to build out our state federal funding so that we can grow these programs over time.”
Examples of support that could come include a six-month form of rental assistance, and potentially reimbursing programs that provide meals to people on Medicaid. Project Angel Heart hopes the meal reimbursement becomes a reality, as a nonprofit organization that has served millions of meals to Coloradans who are severely ill and have specific dietary needs.
“We can take one menu item and differentiate it in about 200 different ways to meet the specific dietary needs of each of our clients. On average, we tailor these meals in about 80 different ways each week," said Nic Soucy, the Government Affairs Manager for Project Angel Heart. “We don't necessarily require that our clients provide us information about their insurance status, but about 80% of our clients live at or below 200% of the federal poverty level.”
Soucy said, presumably, many of their clients do benefit from Medicaid. She hopes the proposal from the state will include a reimbursement for the meals they serve to individuals on Medicaid.
“If we're able to help meet the needs, the basic needs of Medicaid members, including food and housing, then they're better able to afford other basic necessities and and they can stay healthy. And I think that benefits our community as a whole," said Soucy. “If we're able to receive Medicaid reimbursement to provide these medically tailored meals to folks across the state, that would just allow us to serve more Coloradans.”
In 2018, Project Angel Heart conducted a study that found clients experienced a 13% reduction in hospital readmissions overall, and clients living with COPD, Congestive Heart Failure, and diabetes saw their monthly medical costs go down at an average of 24%.
The state's proposal is due in August, and the public comment for the proposal closes on July 10 at 5 p.m.
The feasibility study must be completed by November, and the goal is to start covering the services in Colorado by July of 2025.
Ultimately, Colorado needs federal approval for the Medicaid expansion.
