Strong Partnerships Protect Patient Care
Oppose Senate Bill 26-041
Colorado’s hospitals are facing historic uncertainty, budget cuts, and increases in uncompensated care. Hospitals thrive when collaboration, innovation and partnership are prioritized, especially as the health care system navigates increasing state and federal instability. And Colorado hospitals support transparency and appropriate oversight of those critical partnerships.
SB 26-041 will disrupt access to care across Colorado by destabilizing the entire health care ecosystem. At a time of unprecedented financial strain and workforce shortages, hospitals need the ability to adapt, partner, and innovate to provide the services that patients need and value. SB 26-041 creates broad, uncertain oversight that could delay or prevent time-critical decisions essential to patient access.
CHA’s Take:
Health care is an interconnected ecosystem: Hospitals anchor a complex ecosystem that includes patients, physicians, nurses, clinics, behavioral health providers, long-term care, emergency medical services, and community partners.
- Transactions and partnerships are often designed to maintain services, stabilize staffing, and coordinate care, not to consolidate market power.
- Disrupting one part of the system can trigger cascading effects – reducing access, increasing costs, and fragmenting care delivery.
- Maintaining appropriate staffing levels is becoming increasingly difficult, particularly in our rural hospitals. SB 26-041 will further magnify these problems.
How the Bill Threatens Access to Care
Broad and Uncertain Oversight Authority
SB 26-041 grants the Attorney General:
- Expansive authority to review, condition, delay, or unwind a wide range of health care transactions based on a subjective “consumer harm” standard.
- Unprecedented authority to require hospitals to provide services, even if staff is not available or the service is too costly to maintain.
- Ability to convert reviews into full antitrust investigations at any point.
- Significant judicial deference for decisions, limiting predictability for hospitals and patients.
The result: Time-sensitive transactions intended to preserve services – such as emergency care, obstetrics, behavioral health, or specialty coverage – may be delayed or cut.
Scope of Review Is So Sweeping It Impacts Nearly Every Hospital
Patient access is at risk and this bill could both accelerate hospital closures and stifle necessary innovation at a critical time in our health care system. The bill captures far more than major mergers and acquisitions, including:
- Contracting affiliations
- Management and service arrangements
- Routine partnerships hospitals rely on to operate efficiently
These arrangements are common across hospitals of all sizes and are frequently used to prevent service disruptions and maintain local access to care.
The result: Hospitals may be unable to form or sustain partnerships needed to keep services available, even when no competitive harm exists.
Vague Standards Undermine Stability, Innovation, and Planning
Transparency should strengthen access to care – not undermine It. The bill inserts undefined concepts such as “consumer harm” and “public interest into the established antitrust legal review, potentially creating a new line of case law. Hospitals will not be able to reliably assess compliance risk, and planning and investment decisions will be slowed or halted.
The result: Communities may lose services not because of consolidation concerns, but because hospitals cannot move forward under unclear and subjective standards.
Provider Referral Provisions Conflict with Existing Law
Patients depend on access to coordinated care across providers, settings, and services. The bill introduces referral restrictions that overlap and conflict with well-established state and federal laws already governing provider relationships. Hospitals and clinicians will face inconsistent legal obligations, and integrated and coordinated care models will be placed at risk.
The result: Reduced care coordination can increase costs, fragment services, and make it harder for patients to receive timely care.
Financial Distress and Risk of Service Line Closures
Colorado hospitals are experiencing unprecedented financial pressure driven by state and federal uncertainty, regulatory stress, workforce shortages, inflation, and inadequate reimbursement.
Partnerships are often the primary tool hospitals use to stabilize finances and preserve services.
Delays or denials of transactions increase the risk of service line reductions or closures, with system-wide access implications.
The result: When hospitals cannot adapt and innovate, patients are forced to travel farther for care or forgo services altogether.