We are fortunate to have some of the best health care in the nation right here in Colorado. Our health care system is incredibly interlinked, with close collaboration between rural and urban facilities to care for patients across our state.

Unfortunately, that ecosystem of care is more fragile than it needs to be. Since the COVID-19 pandemic, rising costs, staffing shortages and growing regulatory burdens have strained hospitals and clinics across the state.

Now, Congress has passed the One Big Beautiful Bill Act, which threatens to deepen these wounds — cutting Medicaid and putting access to care for thousands of individuals and families in our state at risk.

While this bill has brought our health care system’s issues to the forefront, the truth is the problems we are facing in Colorado have been years in the making.

The challenges already exist:

• More than 500,000 Coloradans have lost Medicaid coverage since the end of pandemic-era protections, including many who still qualify.

• Hospitals and safety net providers face steep and continuing increases in uncompensated care.

• Workforce shortages persist, particularly in rural areas, and supply costs have soared.

• More than 400 state laws and regulations have been passed or adopted since 2019, making it difficult — and expensive — for health care providers to keep up.

Today, more than 70% of Colorado’s hospitals operate with a small or negative operating margin, which means little if any money remains to invest in new facilities, equipment, and personnel. Colorado’s health care system cannot withstand more strain without intentional, inclusive planning.

This is more than a policy problem — it’s a human one. When people lose coverage, they skip preventive care, forgo critical medications, use emergency rooms as primary care locations and face the terrifying uncertainty of whether care will be available when needed. And when providers are pushed past their limits, entire communities will suffer.

Fortunately, there is still time. Many of the Medicaid changes from the bill won’t take effect until 2027 or later. That gives us a window to develop a thoughtful and collaborative policy that secures Colorado’s health care safety net and creates a sustainable, accessible system that works for everyone in our state.

We have a model for how to do it correctly. This year, lawmakers faced a similar crisis in Colorado’s safety net clinics after massive Medicaid disenrollments.

Instead of imposing a one-size-fits-all fix, they partnered with providers, advocates, and policy experts to create SB 25-290. This bipartisan bill established the Provider Stabilization Fund, which will help support community health centers without threatening devastating impacts to the entire ecosystem.

This kind of collaboration should guide us to how we respond to the coming changes. Health policy cannot be effective if it’s crafted in a political silo or rushed without the broad input that helps prevent unintended consequences. The stakes — people’s health, financial stability, and lives _ are simply too high.

Our system of care in Colorado includes outstanding hospitals, accessible clinics and specialty providers. Together these organizations — often the largest employers in a community — support at least 750,000 jobs.

Such a critical stakeholder must be at the table if we want to create real solutions that not only save — but strengthen — our health care system for both patients and the people who provide care.

Looking ahead, we urge legislative leaders to convene a broad, inclusive coalition of patients, providers, advocates, payers and policymakers.

Together, we can work to design sustainable solutions that protect access, strengthen our workforce, and make Colorado a national leader in resilient, people-centered health care.

We have time — but not time to waste. Let’s use it wisely. Let’s lead with collaboration.

Jeff Tieman is the president and CEO for the Colorado Hospital Association. In that role, he provides leadership and direction for the association’s work to serve and advocate for its more than 100 member hospitals and health systems across Colorado.