It’s no secret the state is facing a serious budget shortfall lawmakers will be charged with addressing this legislative session. This reduction in funding is forcing cuts to state programs and services, jeopardizing our ability to fund our public schools, and generating an array of plans and policy ideas for backfilling the shortage — some innovative and some shortsighted. 

Unfortunately, Colorado policymakers seem to continue to resort to slashing Medicaid payment rates for physicians and health care providers as a means to shore up the deficit. Though there were recommendations from the state’s Medicaid Provider Rate Review Advisory Committee for rate bumps for certain providers, they are unlikely to make it to the final budget and with the cost of inflation, most providers will see a cut regardless. We believe this type of planning is profoundly short-sighted — and is detrimental to patients and providers alike.

As a pediatric anesthesiologist, my priority — like all physicians — is to ensure the health and well-being of our patients and to ensure all Coloradans can access high-quality, equitable health care. We do not pick our patients or inquire about their ability to pay. However, continued cuts to Medicaid payment rates by decision makers increase already significant inequities in health care specifically for rural Coloradans, low-income patients and patients of color and exacerbates staffing shortages, all while not meaningfully reducing health care costs.

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Though it may just seem like a line item on a spreadsheet, cutting payment rates has real consequences. It means reducing access to high-quality physician-led care in our emergency rooms and surgical centers, in our labor and delivery rooms, and even in local doctor’s offices where rural patients in particular have less and less access to preventative care. It also means reducing access to health care for our children — one in three Colorado kids are served by Medicaid at birth.

Nor are the effects of these cuts felt equitably in our state for adults. Medicaid programs cover one in four Coloradans, and 66% of these patients identify as BIPOC. Though the majority of Medicaid patients live in urban centers, more than 20 rural counties rely on Medicaid to serve more than 35% of their population. Three rural counties rely on Medicaid programs to serve more than 50% of their population.

These reductions also mean providers could be asked to rely on more dated, less expensive treatment for Medicaid patients as we have seen across specialities. For example, 60% of pregnancy patients use an epidural — the most effective form of pain control during labor, which is also shown to reduce the risk of postpartum hemorrhaging. Yet Black and Hispanic women are significantly less likely to receive epidurals than white women, more likely to receive general anesthesia, and more likely to have any type of severe morbidity. 

In addition, cutting Medicaid payment rates, though having little effect on hospital profits, results in provider salary cuts. This means practices closing their doors, exacerbating the health care staffing crisis further. The decisions of our policymakers are also forcing the next generation of highly-trained, dedicated and sought-after physicians, physician assistants nurses and other health care practitioners to look to provide care in other states.

Continuing to reduce funding for critical medical care hurts both patients and providers. We are already facing serious health care staffing and access issues and these types of policies put our vulnerable communities — including our kids — at an even greater disadvantage. Though we understand the state has a budget shortage, it should not be balanced on the backs of Medicaid patients who already face serious barriers to health care.

Dr. Megan Nash-Mozer is a pediatric anesthesiologist in Colorado.