The $900 billion in Medicaid cuts over the next decade could threaten the viability of more than 400 hospitals nationally and at least nine in Colorado, a new report has found.

The hospitals span the Front Range and rural communities, from Denver Health — the region’s primary safety-net provider — to smaller hospitals in places like Leadville, Lamar and Fort Morgan, reflecting the mounting pressure across both urban and rural health systems.

“The cuts will be devastating to many low-income and disabled individuals who rely on Medicaid,” the report said.

“Moreover, they will have knock-on effects on hospitals that disproportionately serve these communities, deepening the financial strain already plaguing rural and safety-net hospitals and compromising their ability to deliver care, potentially leading many to close.”

The Public Citizen report identified the hospitals most at risk of reducing medical services or closing using three years of data. Hospitals with a high Medicaid payer mix (20% or greater) and a negative net profit margin were categorized as “at-risk.”

The Colorado hospitals at risk of closure are:

• North Colorado Medical Center (Greeley)
• Longmont United Hospital
• Platte Valley Medical Center (Brighton)
• St. Elizabeth Hospital (Fort Morgan)
• Denver Health
• St. Vincent General Hospital (Leadville)
• UCHealth Grandview Hospital (Colorado Springs)
• St. Mary-Corwin Hospital (Pueblo)
• Prowers Medical Center (Lamar)

The financial situation is dire, but officials at several of the Colorado hospitals identified as at risk — including Denver Health and UCHealth in Colorado Springs — said their health systems are not in danger of closing.

“A closure is really not on the table,” Donna Lynne, CEO of Denver Health, told The Denver Gazette. “We’re not closing the doors.”

Nor does Lynne foresee any service reductions.

But with nearly half of Denver Health’s 280,000 patients on Medicaid, the cuts will mean “belt tightening.”

Lynne said as many as 20,000 could lose their Medicaid eligibility with new requirements that include recertifying twice annually.

“We’re going to do everything that we can to make sure that they stay on Medicaid,” Lynne said.

In 2024, Denver voters approved a 0.34% sales tax increase to generate $70 million in additional revenue for Denver Health. Its passage made the city’s 9.15% sales tax rate the highest among the 10 largest cities on the Front Range.

Passed eight months before the Medicaid cuts to pay for direct care, the roughly $60 million the health system expects to lose essentially puts Denver Health in the position it was before passage.

“It’s almost a wash,” Lynne said.

Denver taxpayers annually support the region’s safety net.

“President Trump’s Big Beautiful Bill will make it more difficult for Denverites to access and afford healthcare and will create harm for low-income families and children,” Jon Ewing, a spokesperson for Denver Mayor Mike Johnston, said in a statement.

“We will continue to financially support our healthcare system as best we can, but no city or state can possibly hope to cover the funding gaps this bill has so cruelly created.”

UCHealth officials, facing similar concerns about Medicaid cuts, struck a similar tone.

“Like all hospitals, UCHealth is concerned about potential Medicaid cuts and a possible rise in uninsured patients,” Kelli Christensen, a UCHealth spokesperson, said in an email.

“Even so, UCHealth Grandview Hospital is not at risk of closing and will continue to provide emergency and specialty care for patients in Colorado Springs and the surrounding communities.”

Established in 2016, UCHealth Grandview Hospital is a 57-bed micro hospital.

In rural Colorado, St. Vincent Health in Leadville echoed its urban counterparts.

“While reports highlighting challenges facing hospitals across Colorado reflect real pressures in today’s health care environment, St. Vincent Health in Leadville remains positioned for and committed to maintaining access to high-quality care close to home,” Karen Onderdonk, a St. Vincent spokesperson, said in a statement.

The hospital has had financial uncertainties before. Just three years ago, cash strapped and unable to pay staff, the hospital might have closed if not for local, state and federal partners stepping in to avert the financial calamity.

Colorado has defied the closure trends seen elsewhere.

But with nearly seven in 10 operating on thin or negative operating margins, the streak could be coming to an end, said Cara Welch, a Colorado Hospital Association (CHA) spokesperson.

CHA estimates Colorado could lose $10.4 billion in federal funding by 2032 under the “One Big Beautiful Bill” Act signed into law on July 4.

“That reduction will be devastating to Colorado, as the state budget has no ability to backfill that amount,” Welch said in an email. “The entire health care system will feel the impact.”

In Colorado, Medicaid covers about one in four Coloradans.

The state program has also been a growing pressure point for the state budget, with costs rising sharply in recent years. The state’s top Medicaid official, Kim Bimestefer, stepped down last month.

As many as 150,000 Coloradans could lose health insurance, largely due to changes to Medicaid, according to a KFF analysis.

Jointly funded by the state and federal government, Medicaid provides health coverage to low-income residents, including children, pregnant women, seniors and people with disabilities.

The program is overseen by the Department of Health Care Policy and Financing, or HCPF.

Marc Williams, a HCPF spokesperson, said they were unable to provide additional comment on deadline, but directed The Denver Gazette to online materials outlining the expected impacts of H.R. 1.

Nicknamed the “Big Ugly Law” by opponents, the law is expected to cut up to $911 billion in Medicaid and CHIP (Children’s Health Insurance Program) spending over the next decade, according Congressional Budget Office estimates.

The bill passed with no Democratic support.

“We’re facing a health care crisis, and this administration is only making things worse,” U.S. Sen. John Hickenlooper said in a statement. “Colorado hospitals are at risk because the White House cut health care to fund tax breaks for the wealthiest, all while families are paying double or triple for care.”