By Kara Johnson-Hufford | March 11, 2025
If you’ve seen the news, you know Colorado’s mental and physical health care safety net is in crisis. Lay-offs and closures in clinics, hospitals, and centers across the state have made that point visibly and abundantly clear. The number of uninsured in Colorado grows weekly, a reality that providers like safety net behavioral health providers – who provide care regardless of ability to pay both by mission and law – see all too clearly. Among CBHC’s members, the cost of care provided to individuals without insurance amounted to nearly $97 million in 2024 – and there is no funding source available at this time to cover that gap.
In some ways, we’ve lost sight of what a health care safety net is intended to do. Some of our assumptions about how it works hurt those who need access because they hurt the providers who give that care. Here’s a look at some of the misconceptions that are making it difficult to get to a meaningful solution to the current crisis for our state’s mental health care providers.
Misconception #1: There is no definition of the health care safety net. The health care safety net is a well-established system of health care coverage programs and health care providers working together to ensure that all Coloradans who are low-income, living with disabilities, at-risk, and/or aging have access to mental and physical health care, regardless of ability to pay. This is particularly true for our community mental health centers who are often forgotten as part of the safety net but have the same mission and legal obligations to serve all who come through our doors regardless of their ability to pay. We call it a safety net for a reason. It takes an integrated, fully functional effort to ensure that people who need it get access and providers to give the care can survive.
Misconception #2: Mental healthcare is different from physical healthcare. When you read that sentence, you certainly see the error in the idea that the care provided for challenges people face with their mental health is somehow disconnected from physical health. Of course, they are not. Yet too often, mental health care providers are not included in solutions-based conversations about funding and overarching health care system reforms.
Misconception #3: Simply funding the Primary Care Fund will solve the current health care safety net challenges. Let’s be clear. CBHC and our members support the Primary Care Fund and recognize its importance to our other safety net provider partners, including Colorado’s federally qualified health centers. We believe it should be funded adequately to help them carry out their critical mission. But we also know that Colorado law precludes mental health and substance use treatment providers from accessing the Primary Care Fund. Solely funding this one option will not create the access many of our most vulnerable neighbors need.
Misconception #4: Mission-based safety net providers focus too much on funding. In organizations that serve as safety net providers, people deliver the care. Employee wages and benefits account for the bulk of the budget of every safety net provider. For too many years now in Colorado, community provider rates have been unable to keep pace with the actual cost of providing care. If we truly want to fulfill the vision of Governor Polis’s Blueprint for Reform, including a network of providers that offer services to patients regardless of their insurance status or ability to pay, we must develop a financing model that supports it.
There is no doubt that Colorado is in a tough budget year and that proposed federal cuts to Medicaid pose an existential threat to our state’s healthcare safety net. We understand that massive funding increases are unlikely. However, we must prioritize protecting the investments made over decades in our safety net – investments that have led to improved health outcomes, a stronger health care system, and economic benefits for all Coloradans. And it is more important than ever that we come together to explore creative, long-term solutions to ensure that the safety net remains strong, resilient, and prepared to meet future challenges.