April 15, 2026

CHA responds to a recent report by Public Citizen that suggests that 446 hospitals nationwide, including nine in Colorado, are at increased risk of closure due to federal Medicaid cuts:

As CHA has been reporting regularly, Colorado’s hospitals face challenging circumstances. Nearly 70 percent operate with thin or negative margins after multiple years of increasing supply costs, regulatory requirements, and growing administrative and reimbursement challenges. And unfortunately, after more than 40 years without a hospital closure in our state – defying the trends that led to closures that were prevalent in other states across the country – in the last two years we have seen facility closures, service lines eliminated, and workforce reductions.

 

While we can’t confirm the methodology of this report and its list of at-risk hospitals, it is in line with some of the trends we have observed. It is important to note that the report only uses two metrics to determine at-risk hospitals: payer mix and net margins from 2022-24. There are many key elements of a hospital’s financial condition, including patient service margins, days cash on hand, reserves, occupancy rate, and more.

 

With that said, the report does highlight a significant challenge headed for hospitals across the country, as H.R. 1 dramatically reduces the amount of federal funding available for health care. In Colorado, CHA estimates that it will mean a $10.4 billion decrease of federal funding to Colorado, due to cuts to the hospital provider fee by 2032. That reduction will be devastating to Colorado, as the state budget has no ability to backfill that amount. The entire health care system will feel the impact.

 

Colorado hospitals work hard (independently, as a system of hospitals across the state, and with the Polis administration and other stakeholders) to avoid unnecessary closure or reductions in an effort to keep health care services in communities across the state. Despite these efforts, we are past the point of anticipating negative impacts to care – now it is happening, and it will get worse as more provisions of H.R. 1 take effect.

 

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