Posted on January 23, 2024

New Immigrants Pose ‘Difficult Dilemma’ as Denver Health Sees Thousands of Unpaid Medical Visits

Nicole C. Brambila, Denver Gazette, January 18, 2024

Denver Health — the city’s hospital safety net — saw $10 million in additional “uncompensated care” in the last year, which the health system largely attributed to the tens of thousands of medical visits from immigrant patients from South and Central America.

The rise in costs coincides with — and health officials attribute to — the unprecedented number of immigrants, who have crossed America’s border illegally and arrived in Denver.

“Overall, these patients don’t have medical insurance,” said Dr. Taylor McCormick, associate director of Pediatrics Emergency Medicine at Denver Health. “Denver Health is eating the cost for many of these visits.”

Uncompensated care includes health services that are provided, but not reimbursed, often because patients lack medical insurance or the ability to afford the cost of care.

Denver Health does not track — nor does it ask — the immigration status of its patients.

This group of patients were identified as new to Denver Health, as those without medical insurance and from one of the following countries: Colombia, El Salvador, Ecuador, Guatemala, Honduras, Nicaragua and Venezuela.


The estimated payment for clinician services to Denver Health this year is $73.1 million, which reflects a 6% increase, said Emily Williams, Denver Public Health and Environment spokesperson.


Many of these new patients have underlining medical conditions or have run out of or no longer have prescriptions, McCormick said. A large number also suffer from diarrhea, rashes and skin conditions, as well as injuries associated with the nearly 3,000-mile arduous journey from Venezuela to the United States.

“It’s not surprising when they get to Denver that there’s severe and acute health care needs,” said Dr. Steven Federico, chief government and community affairs officer for Denver Health.

Health care providers at Denver Health have also seen chickenpox cases among immigrants, many of whom have lived in congregate settings that can foster the spread of disease.

Chickenpox is a highly contagious disease that causes itchy, blister-like rashes and requires about 82% of the population to be inoculated.

“We’re certainly worried about seeing rises in vaccine preventable diseases,” McCormick said.

As of noon Tuesday, Denver had welcomed 37,571 immigrants.


The city has been reimbursed roughly $14.1 million of the $38 million in associated expenses, meaning Denver taxpayers are picking up most of the tab.

Denver Mayor Mike Johnston has already asked department heads to find 10%-to-15% in savings to brace what is expected to be a $180 million cost this year, if the crush of new arrivals does not abate.


In 2022, Denver Health saw $125 million in “uncompensated care.” Last year, it ballooned to $135 million. In 2020, the price of uncompensated care stood at $60 million.


Federico estimated that the bulk of the $10 million difference in uncompensated care between 2022 and 2023 was related to the influx of new immigrants using the health system.


The surge in new immigrant patients from South and Central America equates to roughly 8,000 people and 20,000 visits, Federico said.

Numbers like that — for an already strained health system emerging from the COVID-19 pandemic — is not sustainable, he said.

“There’s going to be a point where the numbers make this very, very hard,” McCormick said. “We’re already past the breaking point, to a certain extent.”


The city is sheltering — at taxpayer expense — about 4,500 immigrants, who, without the ability to work, won’t be able to sustain themselves, let alone pay for health care.

“The more patients that we see, that threatens the idea that anybody can come and get excellent care here,” McCormick said.

In 2021, Colorado had $78.8 million in emergency health care expenses for immigrants living in the U.S. without authorization, according to Health First Colorado, which administers the state’s Medicaid program.