Why Insured Colorado Families are ‘Drowning’ in Medical Debt

This story is a capstone project by CU Boulder’s News Corps students Ashley Budy and Kathryn Cronin.

Julie Saenger expected a routine surgery to end her daughter’s pain. Instead, it ignited a financial crisis that still hasn’t ended.

It was October 2021, while Saenger sat in a waiting room at Children’s Hospital Colorado Anschutz as surgeons repaired her 11 year old daughter Cece’s hernia—a common procedure meant to dissolve months of chronic pain.

It didn’t.

The surgery failed. The hernia site never fully closed. After months of her daughter’s continued complaints, Julie returned to the surgeon to find out what went wrong.

“I have done this surgery for 30 years, and this has never happened,” the doctor told her.

In October 2022, Cece needed a second operation to correct the first. But for the Saenger family, the damage extended far beyond the operating room. Because the corrective procedure fell in a new calendar year, their insurance deductible reset—forcing them to start over financially for a mistake they didn’t even make.

The surgeon waived her fee for the second surgery. The hospital did not.

“We still had to pay for everything else,” Julie said. “The beds, the hospital stays, the medication, the anesthesia. Everything.”

Across Colorado, families like the Saengers are discovering a harsh reality: having insurance no longer guarantees financial protection. 

Medical debt in the state has climbed to roughly $1 billion, with about one in five adults reporting they have been forced to delay care or make trade-offs with basic expenses. Rising deductibles, fragmented billing and shifting federal policies are increasing the strain, even for middle-class families who have coverage.

A system that resets but never relents

For the Saenger family, the bills didn’t stop with Cece. Five months later, in March 2023, Saenger’s son, Logan, underwent major scoliosis surgery. This marked a third procedure in three years and a third deductible reset. 

New bills arrived while the previous ones remained unpaid. Julie and her husband, Reno, are both self-employed. Without a corporate plan to negotiate rates, they buy their own insurance and shoulder the full weight of the risk.

“We had horrible health insurance, which meant paying more money out of pocket,” Julie said. “By the end, our pockets were empty.”

The math of the Saenger household is a representation of systemic exhaustion: roughly $2,600 a month in premiums—more than $31,000 a year—before a single bill was paid. On top of that, a $10,000 deductible per child, per year.

“We had spent hours in the hospital’s financial office trying to qualify for financial aid or any sort of payment plan,” Reno explained.

Eventually the calls came.

“Getting those calls from collections was like getting hit in the face with a brick wall,” Julie said.

Julie shielded her family from the stress. One night after a call, she drove to her mother’s house instead of going home.

“I just broke down,” Julie confessed.

Searching for answers at any cost

Across Colorado other families are navigating different failures from the same system. Not just the high costs, but delayed diagnoses, repeated procedures and bills that multiply long before answers arrive. 

For Elia Magana and her family, the financial burden began far before a diagnosis ever came. Elia had struggled with stomach problems since she was 10 years old. Her family sought answers, but what they received instead was a series of confident yet incorrect diagnoses.

“The very first doctor I went to diagnosed me with the wrong thing,” Elia said.

Her family didn’t give up. They got a second opinion. Then a third. Then a fourth

Two years. Sixteen biopsies. Five doctors. And a growing pile of bills.

What many patients don’t realize is that each step generates separate charges—lab work, physician fees and pathology—billed individually, not as a single episode of care.

“All of my parents’ savings went to pay off the deductibles,” Elia said.

Specialist visits cost $350 each, twice a month, often outside insurance coverage. Additional tests were frequently denied.

The financial strain spread through every part of their lives. The household switched to a gluten-free diet, raising grocery costs by about 30%. Elia developed severe vitamin deficiencies. The family paid out of pocket for a trauma-focused child psychologist. At one point, she was taking 17 supplements daily.

“We had to take money out of Elia’s 529 college fund to pay these bills,” her mother, Allison, said. “As a mom, all you want is to help your children. Elia kept asking when she would get better, while all the doctors were asking for was more money.”

The emotional toll was just as heavy.

“There were so many nights when I couldn’t fall asleep because I was so worried about what could happen to me,” Elia said. “After so many doctors not having answers, I honestly wanted to give up. I was tired, and I felt awful for putting my family through all of this.”

It took three years before a fifth physician identified the problem: celiac disease.

“When I finally got the diagnosis, I remember asking multiple times, ‘Are you sure?’ Elia said. “It took me a long time to believe that it was over and get that sense of relief.”

How the system stays broken

These experiences are not outliers. They are symptoms of how the system is structured.

Mark Prather, an emergency physician with more than 25 years of experience and founder of a national clinical staffing organization, has seen it firsthand.

“There were many times I knew that a patient was not going to fill their prescription or obtain follow-up with the specialist they were referred to,” Prather said. “I often saw those same patients return to the emergency room in worse condition because of their inability to follow their care plan.”

Part of the problem is structural. Emergency visits often generate multiple charges—one from the physician and another from the hospital. In Denver, that combined total averages around $2,400. The physician receives about $300; the hospital charges roughly $2,100.

“Most patients did not understand this difference and were shocked by the size of their bill.” Prather said. “Many of our hospital systems were very aggressive in collecting those fees.”

Colorado requires hospitals to post prices publicly, but compliance has been inconsistent. Even when available, the data is often buried in complex spreadsheets that patients struggle to interpret. A Gallup survey found 73% of Americans didn’t know they could look up hospital prices at all.

“I had no idea I could look up the price beforehand,” Julie said. “Why didn’t they tell us that?”

Meanwhile, the structure of the industry has shifted. Physicians are increasingly employed by large systems, reducing their ability to advocate independently for patients.

He estimates that up to half of the nation’s disease burden stems from social factors—poverty, housing instability and lack of transportation—that medicine alone cannot solve.

“We spend more on health care than most Western countries yet are ranked near the bottom in terms of outcomes,” Prather said. “Until those structural pressures change, patients will continue to face a system that prioritizes revenue, risk avoidance and institutional survival over affordability.”

The pressure is unlikely to ease soon. Policy changes could lead to more Americans losing insurance coverage, while court decisions have weakened protections around how medical debt appears on credit reports. Meanwhile, costs continue to rise.

For families already navigating illness, the financial fallout can linger long after recovery. Three years after her daughter’s second surgery, Julie is still dealing with the consequences.

“I’m so glad my kids are OK now,” she said. “But we are still drowning.”