By Naomi Riess | Commentary, Rocky Mountain Voice
Healthcare access in rural Colorado is not an abstract policy debate. It is about whether a family can find a primary-care provider, an expectant mother can receive care close to home, or a patient ends up in an emergency room because there was no timely alternative.
In Southwest Colorado, we know the problem: too few providers, long waits, financial pressure on clinics and hospitals, and a system too often designed around the Front Range.
In 2027, I would pursue a practical, bipartisan Rural Colorado Primary Care Access Act built around four principles: access, provider capacity, sustainability and flexibility.
My proposal would build on ideas in HB26-1096, Colorado Medicaid Access to Primary Care Services, considered by the legislature in 2026. That bill would have allowed Medicaid patients to voluntarily purchase direct primary care without losing Medicaid eligibility or access to other covered services. It passed the House 40-22 with bipartisan support. My opponent voted against it in committee and again on final passage.
But rural Colorado needs more than a change in payment options. If there are not enough providers, changing payment alone will not solve the problem. My proposal would focus on adding primary-care capacity, protecting affordability and monitoring the effect on clinics and hospitals.
Patients who participate should retain Medicaid eligibility and access to covered hospital care, specialists, prescriptions, imaging and emergency services. Because they would pay directly for primary care, the pilot should include affordability safeguards. The goal is to give patients another path to care while testing whether flexibility improves access and reduces avoidable emergency-room use.
We must also address the provider shortage. Colorado should make it easier for qualified nurse practitioners, physician assistants, certified nurse midwives and other licensed professionals to serve rural communities to the full extent safely permitted under state law.
That is why HB26-1092 also matters. It would have addressed medical-staff privileges for licensed midwives at public health facilities. My opponent voted to postpone that bill indefinitely. With rural maternity care increasingly difficult to sustain, we should examine safe ways to expand access to maternity-care professionals.
We should also reduce unnecessary administrative burdens. Local physicians have described how insurance requirements and administrative work can interfere with patient care. Rural practices do not have large compliance departments. Excessive Medicaid enrollment, credentialing and reporting consume staff time that could be spent caring for patients.
I would require the Colorado Department of Health Care Policy and Financing (HCPF) to identify duplicative or disproportionate requirements affecting rural providers and recommend changes that simplify them while maintaining accountability.
Most importantly, this proposal must prove itself. Did access improve? Did it add provider capacity, reduce avoidable emergency-room use and strengthen rural clinics without increasing costs? If not, we should not expand it. If so, we will have evidence for a broader solution.
HB26-1096 already showed that this issue can bring Republicans and Democrats together. Republican Rep. Dusty Johnson and Democratic Rep. Lisa Feret jointly sponsored the bill, and Republican Rep. Carlos Barron supported it in committee and on final House passage. The bill passed the House 40-22.
I would build on that bipartisan work in 2027 with a proposal designed for rural Colorado. Federal funding decisions, hospital finances, workforce shortages and the high cost of providing care in sparsely populated communities all matter. Colorado cannot solve every challenge or replace every lost federal dollar. But Colorado should acknowledge when its own policies have increased costs, added administrative burdens or left available resources on the table. It can remove barriers within its control, reduce unnecessary bureaucracy, protect existing coverage and test practical approaches that expand access without weakening the rural healthcare infrastructure we already have.
Give rural patients more choices. Give rural providers more flexibility. Measure whether it works. And make decisions based on the realities of rural Colorado, not a one-size-fits-all approach from Denver.
That is the kind of practical healthcare reform rural Colorado deserves.
Naomi Riess Candidate for Colorado House District 59 [email protected] (970) 749-5882
Editor’s note: Opinions expressed in commentary pieces are those of the author and do not necessarily reflect the opinions of the management of the Rocky Mountain Voice, but even so we support the constitutional right of the author to express those opinions.