Health insurance in Colorado
- Colorado utilizes a state-run marketplace.
- Open enrollment for 2021 coverage in Colorado will run from November 1, 2020 through January 15, 2020.
- Legislation to create Colorado’s Public (“State”) Option was abandoned in 2020 amid the COVID-19 pandemic; lawmakers hope to revive it in the 2021 session.
- Eight insurers are offering 2020 plans through the Colorado exchange.
- Average premiums decreased by 20% for 2020 (but net premiums increased for many people who get subsidies).
- Nearly 167,000 Colorado residents enrolled in 2020 coverage through the exchange. More than 14,000 others enrolled during Colorado’s COVID-19 SEP.
- Colorado terminated all grandmothered health plans at the end of 2015.
- Colorado adopted the ACA’s Medicaid expansion. Enrollment growth is fourth highest in the nation.
- Colorado has been generally supportive of the ACA and coverage expansion, and was a leader in health reform pre-ACA.
- There are no longer any short-term health insurance plans available in Colorado.
- More than 926,000 Colorado residents were enrolled in Medicare as of early 2020.
- Colorado’s high-risk pool closed in 2014, once individual market plans became guaranteed issue.
Colorado has long been a leader in health reform
Colorado has long been a leader in terms of health care reform. Before the ACA implemented reform on a federal level, Colorado had already made maternity coverage mandatory in the individual market, and had banned gender-based premiums.
Colorado became the second state in the nation to actively pursue single-payer health care, with Amendment 69 appearing on the 2016 ballot. However, voters rejected the push for single-payer by a wide margin (Vermont was the first state to implement a plan to achieve single-payer, but they abandoned that path in December 2014).
Colorado implemented a reinsurance program as of 2020, joining a growing number of states that are using 1332 waivers to obtain federal pass-through funding for reinsurance to stabilize the individual market. Individual health insurance premiums in Colorado dropped by an average of 20 percent in 2020, thanks to the reinsurance program (although after-subsidy premiums increased for many people who receive premium subsidies).
Colorado regulators and lawmakers were working on a public option program that the state hoped to debut in the fall of 2021, for coverage effective in 2022, but the legislation to create it was abandoned amid the COVID-19 pandemic. Lawmakers hope to revive it during the 2021 session.
Colorado’s uninsured rate dropped by nearly half from 14.1 percent in 2013, to 7.5 percent in 2018. The Colorado Health Access Survey found an even lower uninsured rate — just 6.5 percent — which has stayed steady from 2017 through 2019.
The Colorado health marketplace
Colorado utilizes a state-run health insurance exchange, and is one of just three in the nation with a permanently extended open enrollment period (November 1 to January 15).
Eight insurers participate in Colorado’s exchange as of 2020. This is relatively robust compared with much of the country, but coverage tends to be localized and plan availability is concentrated in urban areas. In 22 of the state’s 64 counties, those who shop the state’s exchange have a single carrier option (Anthem Blue Cross/Blue Shield) in 2020.
Average premiums in Colorado’s individual market dropped by 20 percent for 2020, but that was before any subsidies were applied. After subsidies, many enrollees saw higher premiums in 2020, due to lower benchmark plan premiums and the resulting decrease in premium subsidy amounts.
Colorado implemented rules to permanently extend open enrollment to 2.5 months, so it runs from November 1 to January 15 each year.
Nearly 167,000 people people enrolled in private plans through Colorado’s exchange during open enrollment for 2020 coverage. That was down from just over 170,000 enrollees in 2019. But to address the COVID-19 crisis, Colorado opened an emergency special enrollment period for uninsured residents. It ran through April 30, 2020, and 14,263 residents enrolled in coverage during that window.
Read more about the Colorado health insurance marketplace.
Grandmothered plans terminated
Colorado required all grandmothered (transitional) plans to terminate by the end of 2015. There are still grandfathered plans in the state, but all other individual and small-group plans are now ACA-compliant.
Colorado and Medicaid expansion
Colorado is among the 36 states and the District of Columbia that have expanded Medicaid under the ACA. The expansion extends Medicaid eligibility to most nonelderly adults at or below 138 percent of the federal poverty level.
As of early 2020, total Medicaid/CHIP enrollment in Colorado stood at 1.25 million people, which was 60 percent higher than it had been in 2013.
Learn about Colorado’s Medicaid and Child Health Plan Plus (CHP+) programs at the Colorado Department of Health Care Policy & Financing website, and learn about Colorado’s Medicaid expansion in our overview.
Short-term health insurance in Colorado
As a result of strong new state regulations that took effect in 2019, there are no longer any short-term health plans available in Colorado.
Colorado legislators’ positions on the Affordable Care Act
In 2009, Colorado Sens. Mark Udall and Michael Bennet – both Democrats – voted yes on the Affordable Care Act. Colorado’s five Democratic House members also voted yes, while the other two representatives, both Republicans, voted no.
The current Colorado congressional delegation includes Senators Michael Bennett (Democrat) and Cory Gardner (Republican). Bennett supports the ACA, while Gardner opposes it. As of 2020, Colorado has seven representatives in the U.S. House: four Democrats, and three Republicans. Support for the ACA is split along party lines in the state’s House delegation.
At the state level, Colorado was one of the only states that moved in a bipartisan manner to establish a state-run health insurance marketplace. Former Gov. John Hickenlooper, a Democrat, signed legislation authorizing the marketplace in 2011. The state marketplace is called Connect for Health Colorado. The state also adopted Medicaid expansion under the Affordable Care Act.
Colorado’s high-risk pool
Before the ACA reformed the individual health insurance market, coverage was underwritten in nearly every state, including Colorado. People with pre-existing conditions were often unable to purchase coverage in the private market, or were only eligible for policies that excluded their pre-existing conditions or charged them premiums that were significantly higher than the base rate.
CoverColorado was created in 1991 to provide an alternative for people who were not able to get comprehensive coverage in the private market because of their medical history.
One of the primary reforms ushered in by the ACA was guaranteed issue coverage in the individual market. An applicant’s medical history is no longer a factor in eligibility, which means that high-risk pools are no longer necessary the way they once were. CoverColorado stopped enrolling new applicants at the end of 2013, and the program ceased altogether in March 2014.
Medicare coverage in Colorado
By February 2020, there were 926,149 Colorado residents covered by Medicare. About 56 percent of them were enrolled in Original Medicare, with the other 44 percent enrolled in Medicare Advantage plans instead.
Colorado health insurance resources
- Colorado Child Health Plan Plus (CHP+)
- Colorado Department of Health Care Policy and Financing
Colorado health reform at the state level
Colorado enacted legislation in 2019 to create a reinsurance program, and to get the ball rolling on a public option in the state, as described above. The Colorado Health Institute has an excellent overview of some of the key pieces of legislation the state passed in 2019.
Legislation that would have created the public option was abandoned in 2020, however, as a result of the COVID-19 pandemic.
See the bottom of this page for a summary of other recent state-level health reform legislation.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.