Op-Ed on Medicaid by former Prowers Commissioner Wendy Buxton-Andrade

Editor’s Note:  This Op-Ed first appeared in the Grand Junction Daily Sentinel.

Medicaid is a Lifeline for Mental Health in Rural Colorado. We Can’t Afford to Lose It.

By Wendy Buxton-Andrade

Colorado’s small towns and rural communities are in the midst of a mental health and substance use crisis, and Medicaid is a critical lifeline for those who might not otherwise have access to the mental health care they need. As the federal government threatens devastating cuts to Medicaid funding, it’s essential to recognize the life-saving role this program plays in ensuring health care is accessible in every corner of our state.

Rural Coloradans are facing serious mental health challenges, and access to support and services can be scarce. According to the Colorado Rural Health Center, all 47 of Colorado’s rural and frontier counties are designated mental health professional shortage areas, with some counties lacking a single licensed behavioral health provider. 15.2% of rural Coloradans reported being unable to get the mental health care they needed, mostly due to the cost of care or being unable to get to an appointment. Additionally, suicide rates are higher in rural Colorado counties than in urban areas. 7.1% of rural Colorado adults had suicidal ideation in the past year, compared to 6.3% of urban adults, and 23.8% of rural adults with suicidal ideation attempted suicide, compared to 16.4% of urban adults.

Rural Coloradans are already facing a serious crisis of high suicide rates and a lack of accessible mental health and substance use services. Without Medicaid, the situation could become catastrophic.

Medicaid is the largest payer of mental health services in the United States, covering more than one in four adults with mental illness. In Colorado’s rural areas, its importance is even greater. As of 2020-2021, Medicaid and CHIP (the Children’s Health Insurance Program) covered 47% of children in rural communities, compared to 40% in metro counties, and 18% of adults, compared to 15% in urban areas. This gap has only grown in recent years, highlighting Medicaid’s critical role in small towns where jobs with employer-sponsored health insurance are often scarce and hospitals face financial strain.

Without Medicaid, tens of thousands of rural Coloradans would be left without health care. For families already coping with long distances to reach care, provider shortages, and stigma, losing this safety net would be catastrophic. Medicaid allows rural clinics, hospitals, and community mental health centers to stay open and serve people regardless of their ability to pay. It covers essential services, from therapy and medication to crisis intervention and inpatient care.

Rural hospitals and clinics in our state depend on Medicaid funding to keep their doors open and provide essential care to their communities. Medicaid cuts would threaten the survival of rural hospitals, many of which already operate on razor-thin margins. Nearly half of rural hospitals in the U.S. operate at a loss, and Medicaid accounts for a significant share of their revenue. 10 of Colorado’s rural hospitals are facing the threat of closure, and three of them are in immediate danger, according to the Center for Healthcare Quality and Payment Reform. If federal cuts go through, these already financially strained facilities could be forced to reduce services, eliminate behavioral health positions, or close altogether, deepening the mental health crisis in rural communities. Without these facilities, our rural friends and family members, farmers, ranchers, and veterans would be left without care when they need it most.

Colorado’s rural communities deserve the same access to mental health care as anyone else in the state. At a time when Colorado is working hard to address its mental health crisis, the last thing we can afford is a rollback of Medicaid funding. The Medicaid cuts currently being considered by Congress would have serious consequences for rural communities and health systems that are already struggling.

Medicaid is a promise to care for our neighbors and to build healthier, more resilient communities. I urge our elected leaders to protect Medicaid and stand up for the mental health of rural Colorado.

Wendy Buxton-Andrade is Mental Health Colorado’s Vice President of Government Affairs and a former Prowers County Commissioner.

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