State Report Highlights Substantial Changes to Preserve Colorado’s Primary Care and Hospital Safety Net

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Report recommends sunsetting Colorado Indigent Care Program and bolstering Primary Care Fund to help more Coloradans get care


February 1, 2024

Media Contact
Marc Williams
Public Information Officer

Denver, CO - The Colorado Indigent Care Program (CICP) program helps uninsured and underinsured patients with incomes up to 250% of the Federal Poverty Guideline (FPG) access discounted health care at participating hospitals, Community Health Centers and other safety net clinics. While CICP is not health insurance, it has been a financial vehicle for participating providers to recoup some costs for medical services provided to eligible patients.

The Department of Health Care Policy and Financing’s (HCPF) 2024 CICP report underscores the importance of primary care and hospital safety net programs but also forecasts substantial changes to sustain the safety net and provider reimbursement. The report shows CICP continues to experience a steady decline as more people enroll in Medicaid, especially since Colorado expanded Medicaid eligibility under the Affordable Care Act in 2014. Currently, only an estimated 40,000 Coloradans receive discounted health care at participating clinics and hospitals each year through the CICP compared to a peak of about 225,000 Coloradans prior to Medicaid expansion. Recently, 11 clinics and two hospitals have left CICP.

“As health care coverage and financing policies have changed, so too have safety net programs,” said HCPF’s Special Financing Division Director, Nancy Dolson. “The time is right to make additional changes and to do so thoughtfully to ensure access to care remains while reducing administrative burdens for providers and patients alike.”

Funding for CICP participating clinics was eliminated in fiscal year 2021-22. HCPF recommends sunsetting the 40-year-old CICP while enhancing the Primary Care Fund and addressing unintended administrative challenges under hospitals’ financial assistance requirements. HCPF’s recommendations would infuse additional funding into the Primary Care Fund to support access at Community Health Centers and other safety net clinics for patients with incomes up to $36,450 per year for an individual compared to $29,160 per year for an individual today.

“Colorado’s safety net programs have changed over time to better meet the needs of Coloradans,” said HCPF Executive Director, Kim Bimestefer. “Given other safety net programs now in place, HCPF appreciates the collaboration of the General Assembly to enact these recommendations to preserve access to care for low-income Coloradans and reduce administrative burdens for providers and patients.”

For hospitals, HB21-1198 created minimum standards for all Colorado hospitals’ financial assistance programs, referred to as Hospital Discounted Care. Through this law, hospitals are required to screen low-income, uninsured patients for public health coverage program eligibility including Medicaid. Sunsetting the CICP and making needed changes to the Hospital Discounted Care requirements will reduce administrative and billing burdens CICP hospitals experience while participating in multiple safety net programs. If HCPF’s recommendation to sunset CICP is approved, the Hospital Discounted Care requirements will bridge access to care for lower income patients.

“We are calling for these changes because if the untenable status quo remains, more clinics and hospitals are likely to end participation in the CICP while patients will face confusion navigating multiple programs and requirements to access care,” said HCPF Chief Financial Officer, Bettina Schneider. 


About the Colorado Department of Health Care Policy & Financing: The Department administers Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus, and other programs for Coloradans who qualify. These health care programs now cover about one in four Coloradans. For more information about the Department, please visit