Healthcare headwinds in the valley: Part 2

Local efforts to address major insurance rate hikes expected in 2026

[  By Katherine Nettles  ]

Editor’s note: this is the second in a three-part series looking at how federal and state cuts to healthcare funding will impact Gunnison County, and how various local leaders, healthcare professionals and advocates are responding.

In a region that already has some of the highest rates of healthcare in the country, Gunnison County residents are bracing for the myriad impacts of recently passed federal policies that cut and further bureaucratize healthcare subsidies and tax credits and may skyrocket health insurance costs next year. Gunnison Valley Health (GVH) has signaled its distress over this multi-tiered issue, and some of the county’s elected officials are advocating for a change of direction, both at the state and federal level and within the local healthcare system. 

On the heels of this summer’s passage of the Trump administration’s Big Beautiful Bill (BBB) and the US Congress’ decision not to extend premium healthcare tax credits past 2025, the Colorado Department of Insurance has predicted this combination of circumstances will create an insurance premium hike of more than 38% for the western part of the state, including Gunnison County.

GVH CEO Jason Amrich says he is deeply concerned for the estimated 150,000 people in Colorado who will lose their Medicaid or subsidized coverage, for those whose premiums will go up drastically and for the hospital system with its own expenses that must treat patients regardless of their ability to pay.

“So, we will have fewer people on Medicaid, fewer subsidized payers, more uninsured—and we’re going to see that need for care likely showing up in our ER,” he recently told the Crested Butte News. 

The downstream effect these cuts could have, Amrich worries, are that other premiums will go up to compensate for cuts to the system’s funding. “Because quite frankly, I have to pay my nurses and doctors and whatnot,” he says. 

Amrich said he is working on his own solutions, which include conversations with other hospital systems across the state and potential funding mechanisms available through the state. 

Amrich is on the Western Healthcare Alliance board of directors, a network of regional providers in Colorado, Michigan and Utah whose mission is to keep healthcare “local, independent and sustainable.” The Alliance has more than 30 member hospitals or healthcare organizations, almost half of which are Colorado-based. Amrich says he believes GVH can be a leader on the healthcare costs issue through his work with this organization. “Is there a way to make the cost of healthcare more affordable? But the open market is going to be a challenge,” he commented. 

Amrich says GVH must find efficiencies to reduce its costs but also needs to continue expanding services for the community.

“From birth to end of life care… If we don’t provide it, it doesn’t exist in this county,” he says.  

Amrich is also keeping an eye on the Rural Health Transformation (RHT) program, a federal fund authorized by the BBB with $50 billion to be dispersed over the next five years. The RHT aims to allocate $10 billion of funding annually to approved states from 2026 through 2030 to help strengthen rural healthcare. The program is scheduled to release its applications this month, with applications due in October and decisions in December, according to Amrich. “We are really trying to make sure we are communicating with the state so when that comes out we get a chance for access to those funds.”

Meanwhile, Crested Butte mayor Ian Billick has been researching this issue with both the town of Crested Butte and with GVH, among others. Billick shared his concerns for the whole system, as described in last week’s story.

“The different pools of people are getting hit at different times and with different levels of visibility,” he says. “As a remote community we don’t have a lot of options in terms of our healthcare providers. The concern is what kind of pressures does it put the hospital under if people lose them as their provider under insurance, but they start walking into the ER.” 

Billick reached out to Amrich about his concerns for GVH and with GVH’s strategic plans to increase service. 

“I would like to see the hospital articulate on what’s driving premium increases. I’m a little concerned about all the capital projects they are driving,” says Billick. “They have been very aggressive about employee housing and adding more medical services. Maybe, before we do more of this stuff we should consider the effects on premiums.”

He has asked the hospital system to lay out more of an explanation of how they consider premiums when adding more services. “So, it’s great to have a dermatologist locally, but if it drives the costs of my insurance up significantly, maybe I am happy just driving to Montrose for that service” he says. 

“GVH has a critical care designation which allows them to charge higher rates, and I suspect that there might be some higher incentives that may make the hospital work better but have an effect on premiums,” he said. 

Amrich said he recognizes this is more the beginning of the conversation than anything else, “As we navigate these headwinds and keep it local and keep that breadth of services at the center of our focus.”

Billick and others have been advocating for changes in Washington as well, penning letters to state and US representatives. “Until they get a handle at the federal level, extending subsidies and premium healthcare tax credits,” he says, “We have to look hyper local.”

Gunnison County commissioner Liz Smith commented during a commissioners’ meeting this week that according to her conversations with the county’s health and human services team, the new federal six-month requirement to requalify for SNAP and Medicaid will double the work for staff. “And we are getting less money,” she noted of the county’s budget for those subsidies. 

County manager Matthew Birnie emphasized that it will indeed be a problem. He said it has been hard to get a clear picture of what funds will be cut, even when already contracted. “We’ve got a series of grants and other funding that looks okay for now, but we don’t know if there will be more opportunities to continue to pursue that funding. There will be challenges and there will be probably some pain but it’s all really murky now,” he said. Commissioners will consider these unknowns as they commence budget discussions this fall. 

Another strategy has gained traction locally and state-wide: one payer reform. The national nonprofit “One Payer States” was founded in 2009 and has never successfully passed legislation, but in this new era of healthcare crises it held its national conference in Denver last month, and Colorado is one of 23 states that are pursuing universal health care at the individual state-level. 

Next week, we will explore the one payer concept in the third and final story of this series.