Colorado’s health care safety net continues to face significant challenges following the COVID-19 pandemic, according to physicians and advocates. They are urging state lawmakers to take action to stabilize coverage programs and support providers serving vulnerable populations.
Health care costs have risen due to supply chain disruptions and labor shortages triggered by the pandemic. The situation was made worse by what some describe as poor management of the Medicaid eligibility redetermination process, often called the “Medicaid unwind.” As a result, more than 500,000 Coloradans—many with low incomes or facing other barriers—lost their health insurance. This has led to an increase in uncompensated care for hospitals, Federally Qualified Health Centers, community clinics, behavioral health providers, and school-based health centers.
Emergency room physicians report seeing these effects firsthand. “My emergency room physician colleagues and I are seeing it in our departments. As a physician at AdventHealth Avista, my team has worked closely with the clinicians at Clinica Family Health and Wellness over the years. For more than 40 years, Clinica has existed as a medical and dental care provider for low-income and underserved patients in the Boulder, Broomfield, Gilpin and West Adams counties. Over the past two years as the unwind has unfolded, community members who would typically go to Clinica for their care have been getting shuttled away from the high quality, preventive medical care previously provided by their primary care clinic teams to the only safety net that remains for them, the emergency department.”
Federal law requires emergency departments to treat all patients regardless of their ability to pay. However, emergency rooms are not designed to provide ongoing or preventive care that primary clinics offer. Data from the Colorado Hospital Association indicates that hospital emergency departments are now seeing 50 percent more uninsured patients than before or during the pandemic—an increase of over 18,000 uninsured patient visits per quarter.
“We cannot sustain this trend,” one physician said.
Colorado lawmakers have previously prioritized investment in health care access for vulnerable residents. Initiatives include creating a Medicaid disability buy-in program so people with disabilities can access benefits without quitting work or becoming impoverished; opting into Medicaid expansion under the Affordable Care Act (ACA), which halved Colorado’s uninsured rate; and funding clinics and hospitals across the state.
“Historically, Colorado lawmakers have made investing in the health care safety net a priority because they know it is important to the health of individual Coloradans and the vitality of Colorado communities. As a state, we created a Medicaid disability buy-in program to allow Coloradans living with disabilities to be able to access the benefits of Medicaid without having to quit work and impoverish themselves to do it. We opted in to the Affordable Care Act (ACA) Medicaid expansion and cut our uninsured rate in half. We funded primary care clinics and hospitals to preserve and protect access to care in all corners of Colorado. Together, we have made incredible progress in Colorado over the last 20 years.”
Advocates argue that continued investment is needed so these gains are not lost as post-pandemic pressures persist.
