U.S. Sen. John Hickenlooper went to Denver Health on Tuesday to hear how rising health care costs and federal policy changes are affecting patients.

He got an earful.

Hospital staff shared stories about Medicaid patients who lost eligibility — and then a limb or their life.

Dr. Stephanie Augustine, a family medicine physician, told of a patient who could not afford his medication and how his diabetes went unchecked. She didn’t see him again for several years. Instead of discussing medications or screenings, they talked about an amputation.

“This is more than about losing Medicaid,” Augustine said. “It’s about losing a limb — and even life.”

For providers like Denver Health, the challenge is compounded by the realities many patients face: mental illness, substance use, and food and housing insecurity.

Where is a hospital supposed to discharge a patient who is homeless?

Andrea Castro Love, who works in inpatient care management, said she encounters patients daily who live in motels, under bridges and in their cars.

She described a patient she met in November with anaphylaxis. He had been intubated so many times he required a tracheostomy and a ventilator to breathe at night.

“We could not successfully discharge him to his car, knowing he needed a home ventilator,” Love said.

She worked to find him housing he could afford. But a small increase in his disability income triggered a cascade of consequences — he lost his Medicaid coverage, his apartment and his ventilator.

Last month, he accidentally coughed out his tracheostomy.

“He died on April 11, and I will never forget him,” Love said.

Nearly half of the patients at Denver Health — the region’s safety-net hospital — are on Medicaid.

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.

In Colorado, Medicaid covers one in four residents — about 1.2 million people.

The state’s Medicaid program has nabbed headlines in recent months with allegations of a fraudulent billing ring, improper payments for autism therapy and exploding cost in a relatively new program meant to provide health care to pregnant women and children illegally staying in the U.S.

While acknowledging the federal policy changes on eligibility, others have blamed mismanagement of the state Medicaid program, noting the explosive growth in both enrollment and spending. Some also said the state could have done a better job of cushioning the impact of losing hundreds of thousands of people from the Medicaid rolls during the “unwind” period.

An analysis by the Common Sense Institute suggested another culprit for Medicaid’s woes — the legislature, where Democrats have solidified their majority control following the 2018 elections. The authors argued much of the Medicaid spending growth in Colorado stems from expansive policy choices, rather than enrollment or medical inflation. They attribute about $858 million in annual costs to more than 180 health care bills enacted since 2019.

Denver Health officials said they expect to lose about 20,000 Medicaid patients next year when provisions from HR 1 — also known as the “One Big Beautiful Bill,” signed into law by President Donald Trump — take effect.

Last year, Denver Health provided $140 million in uncompensated care.

Uncompensated care includes services that are provided but not reimbursed, often because patients lack insurance or cannot afford the cost.

“We fully expect that to go up as this law goes into effect,” said Dr. Steve Federico, a hospital spokesperson.

Unforeseen medical emergencies are inevitable.

That’s why Christine Gillette’s 70-year-old husband has no plans to retire. Gillette, who became unemployed at 58 after staying home to raise their children, does not have health insurance without his job.

“He’s afraid to retire,” Gillette said.

Most Americans get their coverage through employer-sponsored health plans.

In Colorado, about half of residents receive health insurance through an employer, according to the state health department. About 500,000 have no health insurance at all.

That has implications for all Coloradans, experts and policymakers said.

People without insurance often delay preventive care and instead rely on emergency departments — driving up costs across the system.

Hickenlooper said he hopes the stories shared Tuesday will help persuade his Republican colleagues — he needs to sway at least a dozen — of the urgency of addressing Medicaid and rising health care costs.

Following the hourlong event, Hickenlooper called the state of health care in the U.S. troubling, saying “there’s a lot on the line.”

“This is what I call a cost-of-living emergency,” he said.