As Chief Nursing Officer at HCA HealthOne Mountain Ridge in Thornton, I am sounding the alarm: Colorado’s safety net health care providers are facing a crisis, and our most vulnerable citizens are at risk of losing the care they rightfully deserve. In the end, taxpayers and those with private insurance will be left paying for the state’s mistakes.
Health care providers in Colorado have seen a rapid increase in the number of uninsured patients over the past two years. In 2024, Mountain Ridge’s uncompensated charity-based caseload more than doubled. The cost increased from $55 million in 2023 to $120 million in 2024, largely because the state removed Medicaid benefits from more than half a million people in 2023. Many of those people would qualify for Medicaid today, but they were removed for bureaucratic reasons and the state has made it difficult for them to re-enroll.
Hospitals like ours are forced to absorb the cost and look for efficiencies elsewhere. But we are a lean organization, and we cannot take an ever-increasing hit when the state is already able to cover these patients through the existing Medicaid program.
Let me be clear. My colleagues and I do this work because we care deeply for our patients. We have a moral, ethical, and legal obligation to serve them, regardless of their ability to pay. But when the amount of money our hospital loses increases by $65 million in the course of a single year due to decisions the state made, the legislature should be looking for ways to help us.
Unfortunately, the governor’s office is proposing to make it worse with House Bill 1174. This bill would further stress hospitals like Mountain Ridge and other facilities throughout the state that Coloradans rely on every day for immediate life-saving care, routine checkups, and advanced specialty care. The bill artificially caps the reimbursement amount that a provider can collect from the state employee health insurance policy or small group health insurance policies. Capping our reimbursements would not just impact our hospital’s capacity as the safety net provider for our community; it would make it more difficult for hospitals across the state to maintain and expand the level of services they currently provide.
HCA HealthONE serves more Medicaid and uninsured patients in the metro Denver area than any other provider, and we have the second-highest volume of Medicaid and uninsured patients statewide. We are a critical pillar of the safety net system.While we absolutely agree that community providers need more support, taking away resources from one subset of safety net providers to correct the state’s Medicaid enrollment mistakes only makes Colorado’s health care system more fragile.
While I spend my work days dealing with this state-created uninsured crisis, it’s also personal for me. I am the legal guardian for my adult sister with Down Syndrome, and she was one of the many Coloradans who lost her Medicaid benefits due to the state’s bureaucratic failure. This left her uninsured for months. It caused a significant disruption in her care, as her providers could no longer see her, and her prescriptions were no longer covered. Fortunately, I was able to purchase them out-of-pocket, but no one receiving long-term care should be put in that position. Many families are not able to float these expenses when they lose coverage.
As a nursing leader in Colorado, I had an advantage when navigating the system to get my sister re-enrolled. It still took months of phone calls, emails, and paperwork. And while I had the ability to get her reinstated, many don’t. For the 500,000 patients left without Medicaid, hospitals are left covering the cost. And patients end up delaying care, leading to more expensive emergency room visits that often result in worse outcomes.
House Bill 1174 would force providers to pass costs for the state government’s health care obligations to other patients or to cut back on services. It adds more financial pressure to providers who are dealing with an explosion in uninsured patients, a problem caused by the state.
My colleagues and I should focus on doing what we do best: treating patients. We can’t do that if we are constantly fighting a system that tries to punish one type of provider to benefit another. In a state where providers work across organizations to make sure patients receive the care they need, our elected leaders should work to support us all.
Kristen Fiddes is the chief nursing officer at HCA HealthOne Mountain Ridge.
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