Colorado hospitals provided $141 million in charity care to patients who couldn’t pay during the first quarter of 2025, continuing the steep increases seen in recent years.
The cost of charity care rose 26% compared to the first quarter of 2024, and was roughly double what it had been in 2023, according to data from the .
Generally speaking, hospitals keep track of two types of uncompensated care: charity care, which they never expected to get paid for, and bad debt, when they couldn’t collect bills they determined a patient should owe. A more generous charity care policy could lead to a reduction in bad debt, though both could increase at the same time if significant numbers of patients showed up without the ability to pay.
The Colorado Hospital Association reported that the sticker price value of bills that it couldn’t collect rose from 2024 to 2025, but didn’t share information about the underlying costs to medical facilities.
Metro Denver hospitals reported that uncompensated care was up to start 2025, though the severity of the hit varied.
said its uncompensated care rose 8% in the first quarter, while said the cost of care it wasn’t paid for rose 50% — a number it later said included other charitable activities. didn’t have quarterly uncompensated-care numbers available, but said it treated about 19% more uninsured patients in the first half of the 2025 fiscal year than during the same period in the previous year.
reported a 39% increase at its Colorado hospitals. One major contributor was the state’s “aggressive” approach to removing recipients from Medicaid at the end of the COVID-19 public health emergency, said Stephanie Sullivan, spokeswoman for HealthOne.
“As the largest provider of Medicaid volume in metro Denver, we see patients every day in our emergency rooms and hospitals across the metro area who were once insured and are now without insurance,” she said.
Cara Welch, spokeswoman for the Colorado Hospital Association, said people who lost Medicaid coverage when the public health emergency ended in 2023 and haven’t found another form of insurance still need health care, so hospitals are treating them without payment, she said.
“We have seen charity care increasing throughout the industry, including other non-hospital providers, and in all areas of the state — rural and urban,” she said.
Colorado’s recently adopted likely is a factor as well, Welch said.
The law requires hospitals to assist uninsured patients in applying for charity care and limits bills for people with incomes less than 250% of the federal poverty line, or about $80,000 for a family of four. Hospitals can require qualifying patients to pay up to 4% of their income toward their main bill, and up to 2% of their income for doctors’ fees. After three years, they have to write off any remaining bills.
The law that created the program was passed in 2021 and took effect in September 2022. Since then, charity care has more than doubled, from $326 million in the first quarter of 2022 to $772 million in the first three months of 2025. During the same period, bad debt rose about 46%.
Rep. Iman Jodeh, an Aurora Democrat who sponsored the bill creating the discounted care program, said lawmakers couldn’t forecast how much charity care would increase, but knew that people who couldn’t afford to pay were getting saddled with medical debt.
States need to do all they can to protect their residents from unaffordable bills, especially as the federal government makes it harder to qualify for Medicaid or for insurance on the individual market, she said.
“Bills like this, that enshrine medical debt protection, are going to be more important than ever,” she said.
Hospitals are facing challenges because the cost of providing care continues to rise and Medicare and Medicaid still fall short of covering their patients’ expenses, said Tom Rennell, senior vice president of financial policy and data analytics for the Colorado Hospital Association.
The group has projected that hospitals could lose an additional $10 billion over the next five years as stricter Medicaid rules result in more people going without insurance and states have to reduce their use of taxes on providers to draw down more federal money.
“In this fragile environment, any further state or federal funding cuts pose a direct threat to patient care and the health care services that Coloradans rely on,” he said.
AdventHealth's reported 50% increase in uncompensated care also included other charitable activities.
