Amendment 87 Could Save Western Slope Community Health Centers

Gunnison —The fluorescent lights of the clinic hummed with a low, persistent drone, a sound that became background noise to the rhythm of triage and treatment. For the patients walking through those doors in Garfield, Eagle, and Pitkin counties, the building was more than a medical facility; it was the only affordable primary care option within reach. This reality was the daily existence of the community health centers (CHCs) that served as the backbone of local health access, a network that has now found itself in its most precarious financial position in a decade.

The urgency of this shift is personal for those who have led these institutions. From 2012 to 2023, the CEO of Mountain Family Health Centers, the federally qualified CHC serving the three counties, navigated the complex landscape of integrated primary care. Today, that same leader heads Colorado Community Health Network (CCHN), the body representing all 21 community health centers in the state. It is from this vantage point that the argument for Amendment 87 is made, a proposal appearing on the November ballot that seeks to move Colorado to a graduated income tax structure. The goal is to raise up to $2.7 billion annually for health care, K-12 public schools, and early child care, a rare opportunity to bolster state resources and support a weakening safety net.

The need for such support is starkly visible in the data. Statewide, CHCs are the primary care home for more than 850,000 Coloradans, roughly one in seven people in the state. They treat everyone regardless of insurance or ability to pay, a mission that makes their finances inherently fragile. About half of their patients are covered by Medicaid, and 22% are uninsured, a rate far higher than the statewide average of 5.9%. In 2025, 70% of Colorado’s CHCs reported negative or no operating margins, up from 65% the previous year. Behind these statistics are difficult choices for leadership teams: whether to cut evening hours that working parents rely on, lay off staff, or close a site entirely.

This pressure is set to intensify with the implementation of H.R. 1, a federal bill containing significant changes to Medicaid starting in January. Estimates suggest these changes could leave more than 300,000 Coloradans without coverage over the next decade. Many will lose their benefits due to new, confusing paperwork, processes, and added costs, rather than true ineligibility. When a patient loses Medicaid, the CHC continues to treat them but receives no payment, further straining the organization’s budget.

On the Western Slope, the stakes are particularly high. More than a third of CHC sites statewide are in rural communities, and many mountain towns depend on their local center as the sole source of affordable care. The patients include hotel and ski area workers, ranch hands, child care providers, small-business owners, and seniors on Medicare who cannot afford additional premiums alongside the high cost of living in the valleys. The proposal argues that about 97% of individual taxpayers and 95% of corporate taxpayers in Colorado earn less than $500,000 annually, meaning their rates would decrease under Amendment 87. Only income above that threshold would face a higher marginal rate, and any future changes would still require voter approval under TABOR.

The financial logic extends beyond immediate survival. Funding primary care is framed as a strategic investment, with CHCs saving Medicaid an estimated $900 per patient per year. It is a calculation that balances the human cost of lost access against the fiscal burden of a fragmented system. The question posed to neighbors is not just about tax rates, but about the sustainability of the institution that has stood as a constant in the valley’s health infrastructure. The decision rests on whether the community values the stability of that safety net enough to fund it proactively, rather than reacting to the closures and cuts that often follow financial collapse. The weight of that choice settles quietly in the waiting rooms, where the next appointment is already on the schedule, and the lights continue to hum.