Despite providing critical care to the largest share of Medicaid patients in House District 59, two of our region’s most important hospitals are now operating at a loss. At the same time, new federal policies are making healthcare more expensive and more difficult to access.
Southwest Health System, the only independent hospital in Montezuma County, reported an operating loss of $1.6 million during the first four months of 2026. In Archuleta County, Pagosa Springs Medical Center – the county’s only independent hospital – projects a $3.16 million loss this year. Together, these two critical access hospitals are facing nearly $5 million in losses.
Keeping the doors open at our rural hospitals is essential. When someone suffers a heart attack, stroke or serious injury, the difference between a 20-minute drive and a 40-minute drive can mean the difference between life and death. Beyond emergency care, rural hospitals provide primary care, laboratory services, diagnostic imaging, rehabilitation and countless other essential services close to home.
Even with strong local healthcare, there are times when patients need specialized care that isn’t available in rural communities. That’s why maintaining a strong healthcare system across Colorado is so important – it ensures rural residents can access advanced care when they need it while preserving the local services they rely on every day.
Hospitals like Southwest Health System and Pagosa Springs Medical Center are more than healthcare providers. They are among the largest employers in their communities, economic engines for local businesses and cornerstones of the communities they serve.
Independent hospitals are not the only part of our healthcare system facing new challenges. On Aug. 1, Nebraska became the first state to implement the Medicaid work requirements established under the federal “Big Beautiful Bill.” Experts estimate that 3 million to 8.6 million Americans could lose Medicaid coverage by 2028 because of these new requirements. Here in Southwest Colorado, where 31% of our neighbors rely on Medicaid, those changes will have real consequences.
Arkansas became the first state to implement Medicaid work requirements in 2018. Independent evaluations found the policy did not increase employment but did cause more than 18,000 eligible adults to lose health coverage, largely because of administrative reporting requirements rather than a lack of work. Similar policies have consistently shown that eligible individuals lose coverage not because they are unwilling to work but because of administrative barriers.
At the same time, enhanced Affordable Care Act premium tax credits expired under a Republican-controlled Congress in late 2025, causing health insurance premiums to more than double for many marketplace enrollees. More than half those who purchase insurance through the ACA Marketplace are self-employed entrepreneurs or small-business owners. For many of Southwest Colorado’s ranchers, farmers and small-business owners, these higher costs are creating significant financial hardship.
Combined with major federal healthcare cuts, inflation driven by higher fuel costs and tariffs, and an aging population, these changes mean more people are becoming uninsured or underinsured. That leads to more uncompensated and charity care, placing additional financial pressure on hospitals that are already operating on thin margins. When hospitals lose revenue, they are often forced to reduce or eliminate services. And when a rural community loses a healthcare service, everyone loses – regardless of their insurance coverage or ability to pay.
We need practical and often creative solutions to strengthen rural healthcare. During the 2026 legislative session, I was proud to sponsor HB26-1069, which expanded the ability of emergency medical services to provide in-place treatment. The law is expected to save taxpayers nearly $5 million each year while allowing more patients to receive timely care without unnecessary ambulance transports or emergency room visits.
I will continue fighting to protect access to quality healthcare in rural Colorado. Southwest Colorado is an extraordinary place to live, work and raise a family. It’s worth investing in – and so are the hospitals and healthcare professionals who keep our communities healthy.
Katie Stewart represents House District 59 in the Colorado State House, which encompasses Archuleta, La Plata and San Juan counties and most of Montezuma County. Reach her at katie.stewart.house@coleg.gov.
