Survey shows how Coloradans want the legislature to protect their health care in 2025
Hugh Carey/Summit Daily News archive
With a new upcoming presidential administration and a fast-approaching 2025 legislative session, voters have not been quiet about their health concerns.
Healthier Colorado’s 2024 Voter Opinion Survey results, released on Dec. 19, show the majority of Coloradans seem to agree on a few key issues — even across partisan lines.
“With the upcoming Trump administration, a lot of attention is being paid to new proposals related to public health, so we also wanted to test Coloradan’s opinions related to these proposals,” Healthier Colorado director of communications Mary Kate Morr said during a public briefing.
Healthier Colorado is a nonpartisan, nonprofit organization that uses the voices of Coloradans to impact public health policies. The survey examined public health issues in Colorado that could shape the state’s landscape in 2025, such as vaccine requirements, fluoride in drinking water, mental health services, medicaid access and early childhood protections.
It was conducted by Magellan Strategies and Keating Research, who surveyed 800 registered voters — of which 49% were registered as unaffiliated, 26% as Democrats, 23% as Republicans and 2% as other — across the state from Dec. 4-9.
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Survey questions centered around potential proposals from Healthier Colorado, which Morr said the nonprofit plans to bring to the Legislature in their 2025 agenda.
Here’s what Coloradans said about their health care goals in 2025:
Mental health care coverage
Colorado law already requires health insurance companies to cover services for mental and behavioral health conditions in the same way they cover other medical conditions, which is called “parity.”
While these parity laws are in place at both federal and state levels, Healthier Colorado President and CEO Jake Williams said Coloradans with private insurance are experiencing disparities in coverage of mental health, behavioral health and substance use conditions.
Over three-fourths of Coloradans diagnosed with a mental health condition did not receive aid for medical care from their commercial insurance companies as of 2022, which forces many to pay out of pocket or go “out of network” for the care they need, according to data from Healthier Colorado.
Williams said one problem is the lack of a statutory definition of medical necessity based on generally accepted standards of care, as well as the use of medical necessity denials to limit reimbursement of covered mental health services.
More than four out of five voters would support a potential state law requiring private health insurance companies to cover mental health care that is deemed medically necessary the same way as physical health care, with similar responses across age groups and salary ranges.
The lowest support for a potential bill came from Republicans at 78% approval, with all other demographics showing over 80% support.
Child prosecution
In Colorado, a child 10 or older can be prosecuted through the juvenile justice system if they have violated certain laws.
Survey respondents were asked to choose between two scenarios: one where children 10-11 who commit actions that would be prosecutable for adults are placed in juvenile detention centers, and one where the same children are instead placed in counseling and therapeutic programs rather than being prosecuted, unless the child has committed a serious offense like sexual assault or murder.
The first approach is said to enhance community safety and expose offenders to the consequences of their actions early to deter future criminal behavior, while the second is supported by evidence that suggests children who go through the criminal justice system at a young age are more likely to reoffend later in life.
“Really we tested which of these statements comes closest to the respondents’ point of view,” Magellan Strategies survey research director Courtney Sievers said.
This question had more split results, with 67% of overall respondents saying they prefer the scenario where the child gets counseling, while 21% indicated they believe those children should still be prosecuted.
Women, Democrats, parents and those with salaries over $100,000 were the groups with the most support for therapeutic services. Republicans were the most supportive of placing the children in juvenile detention centers at 34% in support of prosecution and 16% undecided.
Fluoride in drinking water
A slight majority of voters, 54%, said fluoride should continue being added to the state’s local water supply.
Fluoride — a naturally occurring element present in almost all water supplies, soil and plants — can help prevent approximately 25% of cavities when present in drinking water according to the Center for Disease Control.
Many natural water systems in the state already contain appropriate levels of fluoride, though the Colorado Department of Public Health and Environment’s community water fluoridation program helps other systems adjust their fluoride levels.
About 63% of people in the U.S. live in communities with fluoridated water supplies, according to 2020 data from the Center for Disease Control.
“This is a partisan issue in Colorado,” said Keating Research project manager Spencer Keating. “We have three out of four Democrats agreeing that fluoride should be added to our local water supply. The majority of unaffiliateds [agree] at 52%, while we only have 39% of Republicans agreeing.”
Robert F. Kennedy Jr., President-elect Donald Trump’s pick for secretary of the U.S. Department of Health and Human Services, recently said the White House will advise the removal of water fluoridation, even though the department has recommended water fluoridation in the past. Kennedy cites concerns of fluoride being associated with several diseases and developmental disorders including IQ loss, bone cancer and arthritis.
There was a slight age divide among voter support, with the highest support for continuing to add fluoride to water coming from those over 65 (67% agree) and the lowest coming from those aged 18-44 (50% agree).
Vaccine requirements
Child immunization rates are falling in Colorado, particularly because more parents are opting out of the requirement amid a growing number of exemptions.
State law requires all students attending Colorado schools and licensed child care centers to be vaccinated against certain diseases, with the option to file exemptions.
Nearly three out of every four voters said parents should be required to vaccinate their kids before sending them to school or child care. Every demographic group agreed, with the least support coming from Republicans at 58% and the most coming from Democrats at 87%.
Non-parents were more supportive of the vaccination requirement than parents by eight percentage points. The largest support came from respondents over the age of 65, with 87% approving of the vaccinations.
“We’re on the ‘yes’ side of this issue by more than three-to-one in Colorado,” Keating said. “We have strong majorities across all of our demographic groups, and there’s definitely less partisanship than the fluoridation question.”
Medicaid
Next year, the state of Colorado is facing a budget deficit of over $600 million. One possible cut to help the state government save money is removing oral health benefits for adults enrolled in Medicaid programs, which the majority of surveyed voters oppose.
The program provides important dental care for low-income adults. When asked whether this service should be protected from budget cuts, an 83% majority of respondents said yes.
“Across all groups, we’re getting a super high percentage who would like to see this program protected,” Keating said.
Approximately 78% of Colorado voters, including over 68% of Republican respondents, also indicated support for the state investing in solutions to streamline Medicaid since administrative barriers have led to the largest decline in Medicaid enrollment in the U.S. since the pandemic.
“This has resulted in healthcare providers going unpaid and patients losing access to care,” survey results state.
Opinion of public officials
Voters were also surveyed for attitudes surrounding public officials. Slightly over half of respondents, 52%, said they have a favorable view of Gov. Jared Polis (81% of Democrats and 22% of Republicans). Roughly 3% of Coloradan voters participating in the survey said they had never heard of Polis.
Meanwhile, Donald Trump and Robert Kennedy Jr. both held 43% favorability from surveyed voters, with the lowest favorability coming from female voters.
Healthier Colorado takes legislative action
Williams said the questions asked in the poll correspond with legislation Healthier Colorado hopes to introduce during the 2025 legislative session. One example is the question of whether children should be prosecuted for less than serious crimes — the answer was overwhelmingly “no.”
“Yes, we will be pursuing legislation in session this year with that aim,” Williams said. Majority Leader Rep. Monica Duran (D-Wheat Ridge) and Senator-elect Judy Amabile (D-Boulder) were identified as future sponsors on the bill.
There are already several early childhood programs that exist to protect the health of minors in Colorado, though most have not been made into statute.
“We’re going to introduce legislation to put it in statute,” Williams said. “By doing so, we can be better positioned to fund those programs, including from the federal level.”
Williams added that part of Healthier Colorado’s proposed legislation aims to define what “medical necessity” entails when it comes to mental health treatment so that Coloradans can be fairly covered for the services they already pay for.
Rep. Kyle Brown (D-Louisville) and Amabile are both working with Healthier Colorado to bring the Fair Standards of Mental Health Care bill to the legislature, with more sponsors to come in 2025.
“We are still garnering more support from other sponsors as we head into the session in January,” Hidalgo said.
