Colorado health insurance

Public option legislation abandoned amid COVID-19 pandemic; Three insurers are expanding coverage areas for 2021

Colorado health insurance

This page is dedicated to helping consumers quickly find health insurance resources in the state of Colorado. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Colorado health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Colorado; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of Colorado health insurance resources for residents.

Colorado has long been a leader in health reform

Colorado has long been a leader in terms of healthcare 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 healthcare, 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 reduce unsubsidized health insurance premiums and stabilize the state 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, although it grew to 8 percent in 2019. The Colorado Health Access Survey found an even lower uninsured rate — just 6.5 percent — which has stayed steady from 2017 through 2019.

Colorado’s health insurance marketplace

Colorado utilizes a state-run health insurance exchange — Connect for Health Colorado — which is one of just three exchanges in the nation with a permanently extended open enrollment period (November 1 to January 15).

The marketplace is used by individuals and families who need to purchase their own health coverage, as well as people who are eligible for income-based Medicaid or CHIP. People buy their own health insurance in a variety of situations, including being an early retiree, being self-employed, or being employed by a small business that doesn’t offer health benefits.

Colorado’s marketplace no longer offers small business health plans, but Kaiser still has exchange-certified small business plans for sale, which employers can purchase directly from Kaiser or with the help of a broker or agent.

Eight insurers participate in the Colorado health insurance marketplace as of 2020, and will continue to do so in 2021. 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.

But for 2021, three of the state’s insurance companies (Oscar, Cigna, and Rocky Mountain Health Plans) are expanding their coverage areas, and the number of counties with a single participating insurer will drop to ten.

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 monthly premium costs in 2020, due to lower benchmark plan premiums and the resulting decrease in premium subsidy amounts. For 2021, the eight insurers have proposed an overall average rate increase of just over 2 percent.

Read our overview of the Colorado health insurance marketplace – including news updates and exchange history.

Colorado open enrollment period and dates

Colorado implemented rules to permanently extend its annual open enrollment period to 2.5 months (November 1 to January 15).

Open enrollment for 2021 medical insurance in Colorado will run from November 1, 2020 through January 15, 2020. This window is an opportunity for new enrollees to select coverage in the individual market (on-exchange or outside the exchange), and for existing enrollees to compare the available options for 2021 and renew or change their existing coverage. Enrollees should also provide updated financial information to the exchange during open enrollment, in order to have financial assistance eligibility based on accurate information for the coming year.

Nearly 167,000 people enrolled in private plans through Colorado’s health insurance marketplace 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.

Learn more about how open enrollment works for individual market health insurance plans, both on-exchange and outside the exchange.

Grandmothered health insurance plans terminated

Colorado required all grandmothered (transitional) health insurance plans to terminate by the end of 2015. There are still grandfathered health insurance plans in Colorado, but all other individual and small-group plans are now ACA-compliant.

Medicaid expansion in Colorado

Colorado is among the 36 states and the District of Columbia that have expanded Medicaid eligibility under the Affordable Care Act. The ACA Medicaid expansion extends eligibility to most non-elderly adults at or below 138 percent of the federal poverty level.

As of mid-2020, total enrollment in Medicaid plans and CHIP plans in Colorado stood at 1.3 million people, which was 68 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 is no longer any short-term health insurance coverage available in Colorado. The state created a special enrollment period for people who had short-term health insurance in Colorado but who lost their coverage because their plan terminated and they were unable to purchase another short-term plan (because insurers no longer offer short-term coverage 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 who is running for Senate against Cory Gardner in 2020, 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 insurance 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 and enrollment in Colorado

By August 2020, there were 938,854 enrollees in Medicare in Colorado. About 56 percent of them were enrolled in Original Medicare, with the other 44 percent enrolled in Medicare Advantage plans instead.

Read more about Medicare in Colorado.

Read more about Medicare’s annual open enrollment period, which Medicare beneficiaries can use to compare available Part D and Medicare Advantage plans and renew or make a change to their coverage.

Colorado health insurance resources

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 coronavirus 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 Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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