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New guidance from the Trump administration has derailed an effort by Colorado to allow babies and toddlers covered by public health insurance to stay continuously enrolled until they turn 3.
Colorado had been planning to roll out its continuous coverage initiative on January 1, 2026. But the guidance, which was released earlier this month, now has advocates worried that thousands of young children from low-income families could lose health coverage at a critical time in their development, with downstream effects on schools, hospitals, and other institutions.
The Trump administration guidance will affect young children enrolled in Medicaid or Colorado’s Child Health Plan Plus program, or CHP+. Instead of allowing them to stay enrolled in the insurance plans until their third birthday, as Colorado leaders intended, their parents will have to fill out paperwork to re-confirm eligibility every 12 months. If they miss the deadline, skip the paperwork, or their income rises slightly above the government’s low-income threshold, their kids would lose coverage.
During the COVID pandemic, the federal government allowed people on public insurance programs like Medicaid and CHP+ to stay continuously enrolled without having to re-submit paperwork every year. When the pandemic ended, some states, including Colorado, sought federal approval to keep the policy going for certain vulnerable populations.
The Trump administration’s new guidance signals an end to that era.
The guidance emphasizes “fiscal and program integrity” as the rationale for ending continuous eligibility for some groups. It also comes amid a broad federal push to shrink a variety of safety net programs. The recent budget bill that Trump signed into law will make deep cuts to Medicaid and the Supplemental Nutrition Assistance Program, or SNAP.
U.S. Sen. Michael Bennet, a Democrat who’s running for Colorado governor, cited some of those cuts Tuesday in announcing a federal bill that would provide continuous public health coverage to enrolled children until they turn 6.
“Guaranteed, consistent coverage during a child’s critical stage of development is especially important now, as the Republican ‘One Big Beautiful Bill’ will cut $1 trillion from Medicaid and CHIP, increase barriers to coverage … and add unnecessary red tape that will lead to people improperly losing their health care,” he said in a press release.
CHIP is a joint federal and state health insurance program for children who don’t qualify for Medicaid. CHP+ is Colorado’s name for CHIP.
With Republicans in control of Congress and the White House, Bennet’s proposal may be a nonstarter.
Madi Ashour, director of K-12 education policy for the state advocacy group Colorado Children’s Campaign, said one of the biggest problems with the federal restriction on continuous eligibility for young children is that they’ll miss doctor visits that could uncover developmental problems and route them to important therapies.
“If a child is dropped for Medicaid coverage during that crucial 0-3 window, they may miss diagnoses or supports for developmental delays,” she said.
Ashour said Colorado’s continuous coverage initiative for babies and toddlers can be thought of as “a workload reduction effort for kindergarten and elementary teachers.”
“Kids who start preschool or kindergarten with undiagnosed or unaddressed developmental delays are much more likely, obviously, to struggle with early literacy, behavior, or even peer relationships,” she said. “That may require more intensive and costly interventions later in the school system.”
A 2023 Colorado law set the stage for the state’s plan to ensure continuous public health insurance coverage for two groups: young children during the first 36 months of their lives and adults in the first 12 months after release from state prison. The state received permission from the Biden administration in late 2024 to roll out the effort starting in 2026, but that permission needed to be renewed this coming December by the Trump administration. It now appears that won’t happen.
Marc Williams, a spokesperson for the Colorado Department of Health Care Policy and Financing, said in an email that plans underway for the Jan. 1 launch are “being urgently pulled back” now.
The department “is analyzing whether it needs to rework legislation and what the fiscal impact may be,” Williams wrote.
Ann Schimke is a senior reporter at Chalkbeat, covering early childhood issues and early literacy. Contact Ann at aschimke@chalkbeat.org.
