The Denver Gazette’s Marissa Ventrelli reports that nearly 70 percent of Colorado hospitals ended 2024 with margins the Colorado Hospital Association calls “unsustainable.” The story, published Oct. 24, 2025, pins the squeeze on costs outrunning revenue while more Coloradans show up uninsured or under-reimbursed. The article centers on CHA’s Tom Rennell, who warns 2025 looks even worse as expenses keep rising faster than revenue.
It gets tougher outside the Front Range. More than 80 percent of rural hospitals could not hit sustainable margins. Since 2019, hospital expenses climbed 52 percent while revenue rose only 39 percent. Charity care is up 123 percent since 2021. Three behavioral health facilities closed last spring, and the reimbursement gap for Medicaid and Medicare was nearly 4 billion dollars in 2024. The association urges policymakers to revisit rules that add cost without helping patients – while bracing for federal budget changes that cut deeper.
The Bullet Point Brief
• Hospitals in the red. Nearly 70 percent finished 2024 underwater. Rural facilities are in even hotter water at over 80 percent.
• Cost curve beats the revenue curve. Expenses up 52 percent since 2019. Revenue up 39 percent. That spread is a chokehold.
• Care without a payer. Charity care jumped 123 percent since 2021 after the Medicaid unwind and a surge in uninsured patients.
• Services cut, care lost. Three behavioral health centers shut their doors last spring, shrinking options while demand climbs.
• Washington’s gift basket. The congressional budget dubbed HR 1 brings work requirements in 2027 and trims provider fees, with the association warning billions in Colorado cuts over five years.
My Bottom Line
Colorado built a health policy Rube Goldberg machine and then acted shocked when marbles fall on patients instead of into a savings jar. When you freeze reimbursements, layer mandates, and swell public rolls during boom times, you get hospital ledgers that bleed during hard times. That is not a mystery. It is math.
The fix is not another glossy program or a press release about “reimagining care.” Start by scrubbing rules that add cost without improving outcomes. Pay honestly for the care you mandate. Stop punching rural hospitals in the wallet. If the state and feds want universal promises, they need universal payment, not universal shrugging. But I do not believe in “universal.” I believe in the free market. So the government should get out of the way and let the free market do what it does best. Different clowns, same circus. Patients are the ones under the tent.
Source: The Denver Gazette
