By Jeff Tieman and Julie Reiskin

Colorado is careening toward a health care disaster, and unless we change course now, too many of our neighbors will bear the cost — in dollars, in well-being and in lives.

Colorado’s health care system isn’t just dysfunctional,  it’s teetering on collapse. Insurance premiums are set to spike dramatically. The Colorado Division of Insurance warns 2026 rates could rise 28% on average, with rural and mountain counties potentially facing 40%-plus increases. These hikes are tied largely to the expiration of enhanced federal tax credits. If these projections hold, as many as 75,000 Coloradans could lose coverage because they simply can’t afford it anymore.

Meanwhile, looming federal and state Medicaid cuts threaten to rip away another pillar of stability. Colorado officials estimate a nearly $1 billion reduction on the horizon, jeopardizing the care of more than a million Coloradans who rely on the program. Layer onto this the escalating pediatric and adult mental-health crisis in our state and it becomes clear we’re facing a systemwide emergency, not a series of isolated problems.

And yet, for all this urgency, Colorado’s health care system suffers from one of its most debilitating flaws: no one owns the whole system. Decisions are made in silos — hospitals over here, insurers over there, state agencies somewhere in between. Policymakers often craft solutions without genuine input from the people who deliver or rely on care. And far too often, our debates start from clashing assumptions instead of shared facts.

That fragmented approach is pushing us toward the edge of the cliff. It’s also why a broad coalition of hospitals, physicians, health plans, behavioral-health providers, rural leaders and consumer advocates came together earlier this year. In a political environment defined by polarization, this group did something unusual: we sat down, challenged one another openly and confronted the uncomfortable truth Colorado is on an unsustainable trajectory.

Across hours of candid discussions, one theme kept resurfacing: if we don’t change how we solve problems, no big or small policy changes will fix what’s broken. We need real accountability for system-wide outcomes. We need policymaking that begins with community voices, not performative “consultations.” And we need decisions rooted in shared, validated data rather than ideology or assumptions.

This isn’t about blaming state leaders or pointing fingers among sectors. It’s about acknowledging health care is simply too large and complex for anyone to fix alone. Challenges such as workforce shortages, affordability pressures, dwindling rural access and regulatory overload are interconnected. They demand a coordinated response.

That is why our coalition has put forward a clear message to the governor, legislators and candidates: Colorado cannot afford another year of fragmented policymaking. We must move toward a model built on collaboration, transparency and shared responsibility. That means engaging the communities most affected by policy decisions before choices are made. It means being honest about both what is working and what is failing. And it means grounding decisions in common data so we can actually measure effect rather than guess at it.

The challenges ahead are enormous: protecting access as Medicaid funding shrinks, stabilizing the individual insurance market before thousands more lose coverage, strengthening support for the providers who serve low-income and rural Coloradans, streamlining the regulatory thicket driving up costs and addressing workforce shortages leaving entire communities without timely care.

But enormous does not mean impossible. With shared values and collective ownership, this moment offers Colorado a rare opportunity to reset. If we choose collaboration over turf battles and evidence over ideology, we can rebuild a system worthy of the people who depend on it. Our coalition stands ready to meet this moment. And we’re asking others to join us, before the cracks in our system become consequences too big to reverse.

Jeff Tieman is president and chief executive of the Colorado Hospital Association, which represents more than 100 hospitals and health systems across the state. Julie Reiskin is co-executive director of the Colorado Cross-Disability Coalition, the state’s premier disability-rights advocacy organization.