All Coloradans should have access to quality health care they can afford no matter who they are or where they live. Yet costs keep rising, forcing many Coloradans to make health care decisions based not on what they need, but on what they can afford. Moreover, access to care is not available to everyone, with specialist care even more limited.

We must answer this question in health care: how do we develop a better product that delivers more at less cost? To get there we need to optimize and leverage technology, our talent, and new ideas. To lower the total cost of care, and retain quality, for Coloradans, we will pull every lever we have, and we’ll find new ones, including looking for ways to better incentivize the results we are looking for.

The Affordable Care Act and COVID-era policies expanded health insurance coverage, reducing Colorado’s uninsured rate from nearly 16% in 2011 to 4.6% in 2023. Now, with federal cutbacks inflicted by H.R. 1 recently passed by Congress, people are soon to lose their health care and uninsured rates and coverage costs will rise again—significantly. We know that families who don’t have insurance often delay getting the care they need—instead resorting to care at costly emergency rooms, many taking on devastating medical debt. The cost of uncompensated care provided by hospitals and doctors is then spread across all patients—driving up costs and insurance premiums for everyone. 

As the federal government cuts its support, working families face more red tape and bureaucratic obstacles to keep their health care. Funding for more affordable care is being cut. And preventable diseases like measles are becoming more prevalent. Federal support is eroding—driving costs up for families, health care delivery systems, and our state budget. Rural and community-based hospitals and providers face closures, workforce shortages, service cuts, and insurer exits. 

We must tackle these problems head on—that includes cost increases, coverage loss, and provider instability. With Congress rolling back health care support, Colorado must make every dollar stretch and do more with less.

During COVID, we experimented and drove important innovations forward, expanding telemedicine, strengthening public health, and improving behavioral health care. We worked together, including with other states, to find solutions. I will lead with that spirit to meet this moment.

Collaborating to Bolster our Health Care Assets

Colorado has to do more as the federal government steps away from promoting health care for all. I will continue to fight federal cuts in the courts, including lawsuits I’ve brought against Trump’s U.S. Department of Health and Human Services and Secretary Kennedy. We will build new, state-led strategies to protect critical programs, and protect, grow, and leverage local and regional expertise to fill the void left by the federal government. 

And I will fight to sustain and leverage key investments made over the last decade—in behavioral health, maternal health, telehealth, our direct care workforce, public health, rural health, research and testing of alternative systems, and Connect for Health Colorado (our state-based Marketplace for individual insurance coverage) as well as our programs providing state funds to fill gaps in Medicaid coverage. 

Creating A Path Forward

As governor, I will issue an executive order standing up a Health Care Stabilization and Innovation Task Force of internal and external experts. This team will set immediate priorities, building on agency-level assessments of the impact of federal cuts on health systems, communities and people, and develop an actionable transparent plan to guide and inform nonpartisan and data-driven health policy and funding decisions.

In addressing our health care challenges, we will take a whole-of-government response that brings together all stakeholders—providers, insurers, public health leaders, consumer groups, philanthropy, and researchers. We will leverage the state’s economic power and oversight authorities as well as form alliances with others including other states and local governments. We will be consumer centric, foster competition, and stay focused—on improving quality and reducing the cost of care for people and families.

Leveraging And Coordinating State Leadership

Today, health care is spread across four state agencies. While each has leaders with expertise who care deeply about peoples’ health and play important roles, at times this has led to competing interests, bureaucratic challenges, and a lack of coordination.

As governor, I will continue the work of prior administrations to spur better coordination, leveraging the Health Care Cabinet, an executive-level team spanning all agencies with health care responsibilities. This team will collaborate with the Task Force; streamline work with a bias to action and innovation including cabinet and governor’s office coordination; have a mandate to work seamlessly on recommended design changes and operate day-to-day more efficiently; work creatively with all leaders to respond to immediate destabilization risks; and lead on long-term transformation.

With this group, I will take on long-term complex challenges like: 

• public and private insurance premiums rising faster than inflation, 
• health benefit erosion, 
• poor coordination and cost-shifting across health coverage programs and markets,
• demographic and public health threats (including an aging population, measles, gun violence, behavioral health challenges, and chronic disease), 
• high-value cost-drivers (such as life-saving specialty drugs) and low-value cost-drivers (such as direct-to-consumer drug advertising), and 
• financing sources and priorities.

As governor, I will bring to Colorado other states’ successful innovations, such as those in Washington State, which streamlined its work with improved health outcomes through the Washington State Health Care Authority. 

Modernizing our Health Care Systems

Colorado’s health care system must shift to lower cost and higher quality, and meet people where and how they live today—digitally, geographically, and demographically. 

That means having a health care system that works for all ages. Older Coloradans and those with disabilities may require longer appointments and care coordination support. Younger people have grown up with technology, and young families often have two working parents. They come to health care with different expectations including access to their own health information and virtual care. We must embrace these as opportunities for new paths forward. 

That means leveraging emerging technologies which show real promise in improving health care quality and access—from higher diagnostic accuracy to virtual care, and establishing guardrails to ensure technology enhances, not replaces, human care and judgment, especially in areas like prior authorization and clinical decisionmaking.   

As governor, I will support technological advances that can help ensure that doctors and other providers have the right data and evidence to make sound decisions and recommendations. We will support advancements like clinical shifts from in person to virtual care which will help the next generation of service delivery, including remote, in-home patient monitoring, digital therapeutics, and home delivery of prescriptions. We will align with others to advance care common today that will continue to evolve, such as hybrid virtual and in-person primary care models, over-the-counter birth control, and telehealth for behavioral health. In short, the health care market is changing and will continue to change, and we must capitalize on the most promising advances–always taking a patient-centered perspective.

As governor, I will leverage information technology to reduce administrative complexity across state and private systems; propose appropriate consumer protections; and improve transparency and coordination among health care stakeholders for better outcomes and public reporting. In conjunction with the Health Care Cabinet, our newly appointed Chief Innovation Officer will focus on this opportunity.

We will look to expand approaches, like Colorado’s “Shop for Care” tool, to provide patients with clear, accessible information on healthcare pricing, enabling patients to make informed decisions and preventing unexpected costs. 

We will develop and use data to help us assess our investments, like Oregon is doing for their kids with their Child Well Being dashboard, a resource for policymakers and community leaders interested in investigating and improving the well-being of children in their state.

Focusing On A Smarter Health System for All

As governor, I will push for a more efficient and affordable health care system: 

• At the family level, we will ensure that consumers help guide prioritization and implementation decisions and have access to information to help them make informed decisions. 
• At the state level, we will work to realign Medicaid, Child Health Plan Plus (“CHP+”), Connect for Health Colorado, and individual/small group/state employee markets to better serve people and manage costs.  
• At the health system level, we will prioritize public health and value-based care, population health, chronic disease management, community health, social determinants of health, and make investments in innovative approaches for virtual care backed by systems and workforce development.
• At the federal level, we will pursue every available funding opportunity—including the Rural Health Care Fund or the Reentry Demonstration Opportunity Program—and continue to partner with like-minded states and regional collaborators. 

Ensuring Coverage For All Who Are Eligible under Public Programs like Medicaid

In Colorado, approximately 1 in 4 people rely on Medicaid for their health coverage. When including CHP+, which supplements Medicaid gaps, nearly 40% of our children are covered. Medicaid also supports 60% of people living in nursing homes across our state, and in some rural counties, especially in the south, 2 in 5 people are enrolled in Medicaid. 

Over the last year, the federal government has drastically cut funds for Medicaid, CHP+, and the Marketplace. In response, Colorado stepped up to ameliorate this harm—and we will need to consider how to best continue to do so. As governor, I will keep fighting to prevent rising uninsured rates, worsening health outcomes, and avoidable deaths. 

We can’t afford to let our safety net unravel. To fight back, I will work tirelessly to ensure every eligible Coloradan can enroll and stay enrolled in Medicaid and other critical public programs. We must identify all drivers of Colorado’s underperformance to date in maintaining coverage for eligible people and overcome them. We must address funding gaps, modernize our systems, and remove administrative red tape. That must include streamlining enrollment and meeting new federal rules without allowing them to be barriers to access. 

We will cover all children who are eligible under Medicaid and similar programs. I will look for ways to support Colorado’s progress of extending continuous coverage under Medicaid and CHP+ for young children, including the recent expansion of continuous coverage from birth to age three. We will lay the groundwork for the future if the current federal Administration blocks this progress, and we will learn from other states that have expanded continuous coverage even further. Early investments in the health of our kids will reap benefits for them and all of us. 

As governor, I will sign an executive order to comprehensively examine the structure of our markets and investment priorities. Today Colorado has different design features (health plans, provider networks, payment rules and rates, quality metrics, administrative structures, and IT systems) for each market (Medicaid, Medicare, and our state-based Marketplace—Connect for Health Colorado). Some states have aligned markets and operations, for example, by implementing the Children’s Health Insurance Program through a Medicaid platform, by incentivizing health plan participation across markets, or benchmarking provider rates. Through these innovations, they achieved operational efficiencies as well as smoother coverage transitions. We will explore these and other innovative ideas. We will also build on and explore state and philanthropic options to subsidize coverage for families in need, and support evidence-based services where federal support is falling short. 

Creating and Enhancing Behavioral and Mental Health Services

Colorado is experiencing a behavioral and mental health crisis, especially among young people. As governor, I will work with the Colorado Behavioral Health Administration with a focus on access to care across all groups, provider workforce shortages, substance abuse disorder, and technology impacts on kids.

We will look to these findings as foundational to how we improve care through:

• continuing to increase the number and types of providers, 
• creating a statewide youth mentorship program, 
• expanding co-response teams, pairing clinicians and peer specialists with first responders in behavioral and mental health emergencies such as Denver’s STAR program and Boulder’s CARE program, and
• addressing stigma and prevention through public health campaigns and partnerships with schools, workplaces, and community organizations.

Investing in Public Health

A strong state public health system is key to preventing illness, promoting wellness, and responding to community crises. We will: 

• enhance our own public health infrastructure (ideally working with other states) to carry out the work created by gaps in the federal Centers for Disease Control (“CDC”) leadership;
• prioritize population-level data collection to replace information that would otherwise be lost from discontinued federal surveys, such as the Behavioral Risk Factor Surveillance System and the Pregnancy Risk Assessment Monitoring System;
• support community-based prevention efforts around mental health, substance abuse, chronic disease, gun violence, and maternal and child health; and
• build a resilient public health infrastructure that can respond rapidly to future emergencies while advancing long-term wellness.

Creating More Pathways into Healthcare Professions

To meet growing demand and improve care access, we must rebuild and expand Colorado’s healthcare workforce. Promotion of the care economy and its workforce will be a key pillar of my workforce development efforts. See more here.

As governor, I will strengthen workforce pathways into key talent needs, such as nursing, behavioral and mental health providers, and specialists, with targeted initiatives for rural and under-resourced areas; address root causes that prevent more people from entering and staying in health care professions: low wages, burnout, and lack of faculty and trainers; and partner with community colleges and private employers to identify and implement promising new models.  

We will also re-build talent by spearheading ColoradoCorps, a  service program for young adults which will create paths for new talent into critical health care professions, taking lessons from others like those in Washington state who are expanding behavioral health access with certified peer support specialists, and tapping new ideas such as transitioning Medicaid parents to be coaches and high school students as peer counselors to middle schoolers.

Ensuring Patients are Treated Fairly

As governor, I will push for and sign legislation that provides responsible protections for patients and ensures that the health care market operates fairly for all. As attorney general, I fought against medical debt collectors—championing legislation to clamp down on practices that drive patients into debt spirals and collections. To address undue consolidation, I challenged a monopolistic effort by US Anesthesia Partners to buy up smaller practices and drive up prices for consumers. And I worked to curb surprise billing, hitting patients with unexpected charges on their medical bills without their knowledge at the start. As governor, I’ll keep up this fight and champion policies that put patients first and help elevate those health care systems that treat their patients with honesty and transparency.