Where Did the Coverage Go? Investigating the Impact of Medicaid Unwinding in Colorado

Over the past year, Colorado has seen a noticeable rise in uninsured patients walking through the doors of community clinics.

Colorado Safety Net Collaborative logo with mountain peaks, acronym CSNC, and a net-like globe.In partnership with the Colorado Safety Net Collaborative (CSNC), CIVHC began a data request to understand what happened to more than 500,000 Coloradans who were disenrolled during the Medicaid unwinding. With protections from the COVID-19 public health emergency ending, many residents lost coverage leaving many wondering where they went.

Did they get insurance through their jobs? Are they still uninsured?

These were the driving questions for a recent custom report using the Colorado All Payer Claims Database (CO APCD). By looking at data spanning from 2014 to 2024, and projecting into 2025, the project aimed to uncover trends in insurance coverage and lapses in care—especially for those most at risk of falling through the cracks.

CO APCD claims helped track coverage continuity, changes in payer types, and coverage gaps for individuals before and after Medicaid unwinding. Supplemental Medicaid files were also incorporated for deeper insights, such as disability identification and employer-based insurance coverage, and pairing this with U.S. Census data to understand broader demographic impacts.

Why does this matter?

Ball of yarn that is unwinding and revealing health care cross symbol

Even with insurance, many Coloradans still struggle to afford care. But for those who lost coverage altogether, access to even basic services has become more difficult. Some CSNC clinics have reported a 10-25% increase in uninsured patients’ month over month during 2023, some even doubling.

Understanding who lost coverage and why can help clinics, policymakers, and community based organizations respond with real solutions—whether that’s more targeted outreach, stronger support for transitions to employer insurance, or improved continuity of care. Without this data, policy decisions risk being built on assumptions rather than reality.

It’s about improving health care for real people and ensuring that everyone in Colorado has a fair shot at staying healthy, getting care when they need it, and avoiding unnecessary trips to the emergency room for issues that could have been treated earlier and more affordably.

Additional Resources

If you’re a provider, payer, researcher, or community leader looking to better serve Coloradans at the end of life, CIVHC can help. Through access to CO APCD data, analytic support, evaluation and research services, we work with partners across the state to identify gaps, support better care, and reduce disparities.

Contact us at info@civhc.org