Millions of people in Colorado and across the nation lost their health insurance after the pandemic wind-down ended automatic re-enrollment in Medicaid.
An increasing number of Coloradans without coverage have been unable to pay their medical bills, according to a new analysis from the Center for Improving Value in Health Care, which has left hospitals holding the tab.
Kristin Paulson, president and CEO of the center, said people without insurance frequently delay care, and many end up in costly emergency rooms when things get worse.
"Especially in our rural areas, this can have a devastating effect on hospitals. And in fact, we've seen a number of hospital closures over the past several years because they just aren't able to make ends meet," Paulson observed.
Colorado’s rural Southeast, Northeast and San Luis Valley regions saw the biggest losses in Medicaid coverage between 2024 and 2025. After Congress decided not to extend pandemic-era funding which helped people pay for insurance, an additional 3 million people lost coverage since January of this year. The Trump administration attributes the drop in enrollment to its crackdown on abuse and fraud.
Even bigger losses in coverage are expected when cuts to Medicaid under the Republicans’ One Big Beautiful Bill Act take effect in 2027.
Paulson noted Colorado’s budget and revenue restrictions make it hard for the state to backfill lost Medicaid funding. Paulson pointed out hospitals facing rising uncompensated care costs could be forced to make tough decisions.
"As Medicaid rates go down, we're concerned that there may be hospitals or facilities across the state that are being forced to, or choosing to, accept fewer Medicaid patients. This could prove to be a huge access issue if Medicaid patients aren't able to find a source of care," Paulson stressed.
The analysis taps data from the Colorado All Payer Claims Database. Paulson added her team will continue to monitor and report on changes in federal and state policies to help lawmakers and other stakeholders understand the impacts on their constituents.
"It's not our job to comment one way or another on how a policy should be crafted or what it should do. But it is our job to highlight how those policies, or the combination of policies, are impacting the people of Colorado," Paulson underscored.
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