Western Slope lawmakers push to salvage millions of dollars in funding for Colorado’s rural health clinics
Budget writers say they’ve had to make tough decisions to close the state’s $1.2 billion shortfall
Chris Dillmann/Vail Daily
With Colorado lawmakers staring down steep budget cuts in their 2025-26 spending plan, a bipartisan group of legislators is seeking to salvage funding for rural health centers.
The state’s Joint Budget Committee — a six-member group of lawmakers tasked with writing the spending proposal — earlier this week unveiled their budget proposal, the culmination of months of debate over how to close a $1.2 billion shortfall.
While committee members say they were able to avoid deep cuts to Medicaid and K-12 education, it came at the expense of funding for a litany of other programs, including food banks, free school lunches, and transportation.
In many cases, funding for programs just wasn’t renewed, including millions of dollars that were issued last year to federally qualified health centers. Those clinics serve uninsured and underinsured patients in areas where access to health care is limited.
In mountain communities especially, income disparities can exacerbate uninsured rates, meaning “those clinics are the only safety net right now,” said Sen. Dylan Roberts, D-Frisco.
A 2024 report from the Colorado Health Institute showed that Western Slope counties continue to see the highest uninsured rates in the state.
“The need is immediate,” Roberts said. “We have to help keep these clinics open.”
While care centers were allocated around $6.5 million from the state’s general fund last year, budget writers declined to put any general fund money toward clinics in this year’s budget proposal.
As legislators debated the spending plan on Wednesday on the Senate floor, some lawmakers, including Roberts, successfully pushed an amendment that directs $5.6 million in general fund money to those clinics by tapping into a mix of cash fund and general fund reserves.
Since that funding can be matched dollar-for-dollar by the federal government, they say it will bring around $11 million more to clinics.
“This is a real impact on real people in our communities,” said Sen. Kyle Mullica, D-Thornton, who brought the amendment alongside Sen. Cleave Simpson, R-Alamosa.
The increased funding from the amendment would be in addition to the support that federally qualified health centers receive from the state in the form of Medicaid reimbursements. While the budget proposal calls for a 1.6% increase to the reimbursement rate, that’s below the state’s current inflation rate of 2.8% — and some lawmakers see that as a cut.
A safety net for rural communities
The amendment garnered strong support from Western Slope lawmakers, who said federally qualified health centers are a safety net for lower income patients, particularly in rural areas.
These clinics provide a slew of services, including medical, behavioral, dental, pediatric, and hospice care, even to patients without insurance.
“This is where people are getting the care that they absolutely have to have,” said Sen. Marc Catlin, R-Montrose. “I’ve talked to a number of them. They’re talking about possibly having to close some of these facilities or to extremely cut staff.”
Roughly half of all federally qualified health centers in the U.S. run on negative margins, and financial pressures have only intensified in recent years. The end of automatic Medicaid renewal in 2023 kicked hundreds of thousands of Coloradans off the program, forcing clinics to provide care to those patients without receiving reimbursements through Medicaid.
Now, as Congress flirts with the possibility of cutting $880 billion in federal Medicaid funding over the next 10 years, clinics are bracing for worst-case scenarios.
Western Slope centers like Mountain Family, Northwest Colorado Health and Elevated Community Health, formerly known as the Summit Community Care Clinic, have signaled they may need to cut employees and reduce services in areas already struggling with access to care.
Mountain Family, which operates in Eagle, Garfield and Pitkin counties, already had to lay off staff, freeze salaries and close two school-based clinics to absorb the cost of providing care to patients who lost Medicaid in 2023.
CEO Dustin Moyer said in an interview last month that any “further Medicaid cuts would result in more hard decisions. I’m certain of that.”
Budget writers said the $6.5 million allocated to health centers in last year’s budget was a one-time investment, which the legislature will do for programs in years when the state has more financial wiggle room.
The initial decision not to allocate new general fund money in this year’s budget proposal represents one of the many “painful” cuts members of the Joint Budget Committee say they’ve had to make to close the state’s funding gap.
While committee Chair Sen. Jeff Bridges, D-Greenwood Village, opposed the amendment, he touted a bill he’s sponsoring that would cap state reimbursements to large hospitals and redirect money to federally qualified health centers. The measure, House Bill 1174, is currently pending in the House.
Lawmakers who supported the budget amendment, however, said they were willing to hunt for additional dollars if it meant giving health centers more breathing room.
“Anything that we can do to support those frontline health care clinics is important right now, but it’s also, I think, a budget saver,” Roberts said in an interview following the amendment’s passage. “The people getting care now before it turns into chronic disease or emergency-related services … that’s so much more expensive to care for.”
The Senate approved the 2025-26 budget on Thursday, sending the package to the House, where lawmakers will debate additional changes before it can go to the governor for approval.
The 2025 legislative session ends on May 7.
