Colorado — Colorado’s rural and agricultural communities “have enough challenges when it comes to getting the medical care they need, when they need it,” and the proposed state-government insurance option “could be devastating,” Don Shawcroft, President of the Colorado Farm Bureau, writes in Colorado Politics.

“While lawmakers’ intentions may be good, a state government option would threaten access for the very patients they are trying to help,” Shawcroft says. “Particularly when it comes to rural health care, introducing a state government option to compete with private and employer-sponsored plans could be devastating.”

About one-third of Colorado’s rural hospitals already operate at a loss. “Slashing revenue could be the straw that breaks the camel’s back for many of these facilities… jeopardizing access to care for thousands of patients living in rural and agricultural communities.”

The state-government insurance option would “further exacerbate the physician shortage plaguing rural communities and health care facilities statewide. …Worsening our already notable doctor shortage only serves to reduce options for patients and undermine efforts to provide high-quality primary, preventative and emergency care for rural communities.”

“While there is certainly room for improvement,” Shawcroft adds, Colorado’s uninsured rate remains at historic lows—less than half the national average. The state-government option “would have a minimal impact on our uninsured rate, only lowering it by a paltry 0.1%.”

Instead, state lawmakers should be focused on “practical policy solutions” that build on “what currently works well in our health care system while continuing to address the issues we face. Ultimately, a state government option does neither. It would only further threaten vital access to health care services and treatments for rural communities and patients who already face higher barriers to care than most. That is not the way to fix health care in Colorado.”

An analysis by FTI Consulting last month found that, as proposed, Colorado’s state-government option would cut reimbursements to health care providers by $1 billion over ten years. 83% of Colorado’s hospitals would see a reduction in payments, which may force service cuts, layoffs and facility closures. 

The impact would be “especially pronounced” in rural communities. Up to 23 rural Colorado hospitals would be at heightened risk of closure, according to the FTI Consulting study, and in many of these areas the health care infrastructure is “insufficient to meet the needs of displaced patients.”

Shawcroft adds to the growing cadre of leaders who have expressed concerns about the consequences of a state-government option on rural communities and their health care systems. 

“Multiple studies have shown the public option would be a disaster, costing thousands of healthcare jobs here in Colorado and pushing some hospitals — especially those in rural areas — to shutter,” Eaton Mayor Kevin Ross wrote last fall. 

“It’s hard to see how paying less, giving insurers less incentive to retain and compete, is going to in some way improve the access or quality of services and doctors and physicians in rural Colorado,” Chris Brown, Director of Policy and Research at the Common Sense Policy Roundtable, adds.

The impacts of the state-government option would be disastrous for rural communities says Maggie Elehwany, Vice President of Government Affairs and Policy for the National Rural Health Association: 

“When you’ve got a small rural hospital and it closes, it’s a nail in the coffin of that rural community. How are you going to attract a business? How are you going to keep your school if you don’t have physicians? In rural America, health care is really part of the whole infrastructure of the community.”

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