EDITOR’S NOTE: This open letter was sent to the Daily Yonder and is presented to you in its original form. We believe that the voices of organizations and professionals like the authors of this message speak most truthfully to the lived realities of rural communities in the face of big, federal legislation that spans billions of dollars and affects everything from healthcare to the economy. 

As leaders of rural hospitals, our organizations are lifelines for medical emergencies, medical homes for many, and vital economic engines for our region. Proposed Congressional Medicaid cuts exceeding $750 million over 10 years threaten our ability to serve fragile communities like ours. 

In rural southwest Colorado, we operate in a challenging environment where as many as 30% of patients or more rely on Medicaid – hardworking families, seniors, children, and individuals with disabilities. Medicaid ensures access to preventive care, medications, and hospital stays, allowing them to live healthy, productive lives within their communities. 

We proudly serve whomever walks through our doors, but diminished Medicaid reimbursements create impossible financial scenarios. Medicaid isn’t just for patients; it keeps our lights on and pays our staff – nurses, lab techs, maintenance workers – your neighbors and family members. When we can no longer offer a service, it is lost to everyone in the community, not just those who rely on Medicaid for their benefits. Not only do hospitals provide local jobs, they make purchases from area businesses and bring in revenue that circulates through our communities. Cutting Medicaid means longer travel distances for patients, workforce shortages, limited specialty care, and tighter margins hindering equitable, reliable care. Medicaid is a vital resource in sustaining health and well-being in small towns and remote communities and rural hospitals are the vehicle that ensures that care is delivered. Protecting Medicaid protects rural America. These proposed cuts are not just policy; they reshape access to care for millions. While Congress debates the future of Medicaid, we cannot lose sight of the real lives depending on our health systems financial viability to provide access to care. The patients who show up at our emergency departments in the middle of the night. The parents relying on prenatal care at the only clinic for many miles. The elderly neighbor who depends on affordable home health services to remain independent. Hardworking people managing their mental health and wellness. These are not statistics — these are our neighbors, our families, and the heart of our rural way of life. 

Mercy Hospital, Pagosa Springs Medical Center and Southwest Health System are committed to working together to strengthen rural health care, but we need strong federal and state partners who understand that preserving access in southwest Colorado is not optional — it is essential. We urge policymakers to remember the disproportionate burden on rural communities and protect Medicaid as the cornerstone of care it is. 

Let’s act now to ensure all Americans, regardless of location, have access to the care they need and deserve. 

Joe Theine is the CEO of Southwest Health System, Dr. Rhonda Webb is the CEO at Pagosa Springs Medical Center, and Josh Neff is the President of Mercy Hospital in Durango, Colorado.