The analysis compared the supply of pediatricians, family doctors, nurse practitioners and physician assistants with estimated demand for children’s primary care visits. Nearly 388,000 children — about one-third of the state’s total — live in communities where providers could meet less than 60% of that demand. About 82,000 children live in areas where providers could meet 20% or less. On the Eastern Plains, nearly every child lives in a community with a significant shortage.

The consequences can include long trips for routine care. Cassie Littler, a pediatrician who practiced on the Western Slope for about 12 years and now helps lead policy work for the Colorado chapter of the American Academy of Pediatrics, said families sometimes drove one or two hours to see her in Grand Junction.

Distance and limited appointments can delay vaccinations, developmental screenings and other preventive care, Littler said. Those services can help identify health needs early and protect children from illnesses including influenza, COVID-19 and RSV.

The report points to financial pressures as one reason clinics struggle to recruit and retain providers. Research cited by the campaign estimates pediatricians earn about 25% less over their careers than doctors who treat adults. Rural practices can also have smaller patient populations and difficulty hiring nurses, counselors and other support staff.

More than 600,000 Colorado children receive coverage through Medicaid or the Child Health Plan Plus program. The report says Colorado spends an average of $2,883 annually per Medicaid-enrolled child, compared with roughly $3,200 to $4,000 in neighboring New Mexico and Utah. Those state spending figures do not represent the payment a particular clinic receives for a visit, but Littler said Medicaid reimbursement can still fall short of what practices need to provide comprehensive care, including behavioral health services.

Budget decisions could add to the strain. In March, legislative budget writers recommended eliminating planned stabilization payments for about 271 small, pediatric and rural primary care providers. The payments were intended to support practices that do not already receive cost-based Medicaid reimbursement.

Toni Sarge, health policy director for the Colorado Children’s Campaign, cautioned that reducing funding to save money in the short term could increase costs later if children lose access to care. Littler said further reductions in Medicaid payments could lead clinics to cut services or close, particularly in rural areas where many patients rely on public coverage or lack insurance.

Colorado has reduced the share of uninsured children from 9% in 2013 to 4% in 2023, according to the campaign’s 2026 KIDS COUNT report. But insurance coverage alone does not ensure that families can find a provider nearby.

Ahead of the 2027 legislative session, the campaign is urging lawmakers to protect Medicaid and CHP+ coverage, direct investment to communities with the greatest shortages and consider changes to state fiscal policies that limit funding for children’s health programs. The debate will affect whether families can continue to get preventive care close to home, especially in rural parts of the state.