DENVER, CO – Sept. 15, 2026 – The Colorado Hospital Association (CHA) today released Colorado’s Hospital Provider Fee: Protecting Medicaid Coverage & Access to Care for Coloradans, a comprehensive report examining the history, mechanics, and future of one of Colorado’s most significant health care financing tools – the Colorado hospital provider fee – and the policy attention it requires.

Created in 2009 through bipartisan legislation, Colorado’s hospital provider fee has grown from an estimated $680 million program financing coverage for 100,000 Coloradans to a $5.6 billion program financing coverage for 438,000 Coloradans today. The hospital supplemental payments made possible by the fee fund 51% of total Medicaid payments to hospitals today, making it an essential piece of how Colorado’s Medicaid program provides access to care and coverage. Despite that growth and the changing landscape of health care in America, the underlying policy framework has remained largely unchanged for more than 15 years.

“This report comes at a critical moment for Colorado’s health care system,” said Jeff Tieman, CHA president and CEO. “Our hospital provider fee has quietly become one of the most important tools we have for sustaining Medicaid coverage and access to care, and it’s time we all understood how it works and what’s at risk. Colorado’s health care landscape has changed considerably since the hospital provider fee’s creation, and with more change ahead, this is a timely moment to build a shared understanding of this program and the role it plays in our state’s health care ecosystem.”

The report also highlights federal policy changes under H.R. 1 that threaten to significantly reduce the program’s federal funding. Beginning in 2028, H.R. 1 will lower the federal matching funds available for hospital provider fees, a change expected to reduce Colorado’s program by an estimated $900 million to $2.5 billion annually.

The report emphasizes that Medicaid enrollment and hospital funding cannot be treated as competing priorities – Coloradans need both coverage and access to care. While there are likely no good options ahead, policymakers must commit to carefully evaluating the tradeoffs to mitigate damage and protect Coloradans and the health care system they rely upon.

CHA and Colorado’s hospitals and health systems are calling for a collaborative process to chart the program’s future. The report recommends a working group approach, bringing together the CHASE Board, the Department of Health Care Policy and Financing, state legislators, and Medicaid stakeholders, to protect hospital supplemental payments, preserve Medicaid coverage for as many Coloradans as possible, optimize federal funding opportunities, and keep the fee’s enterprise structure intact.

The full report is available on CHA’s website.