Frequently asked questions about health insurance
coverage options in Colorado
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.
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 introduced another public option bill in March 2021, which was enacted a few months later. It created a quazi-public option program (the Colorado Option) that’s available as of 2023, although it’s essentially standardized plans offered by private health insurers, with premium reduction targets that amount to a 15% reduction in premiums by 2025.
Colorado’s uninsured rate dropped by nearly half from 14.1% in 2013, to 7.5% in 2018, although it grew to 8% in 2019. The Colorado Health Access Survey found an even lower uninsured rate — just 6.5% — which stayed steady from 2017 through 2019.
Colorado utilizes a state-run health insurance exchange – Connect for Health Colorado. And as of 2023, there is also a separate platform (Colorado Connect/OmniSalud) that can be used by undocumented immigrants, since federal rules prohibit people from using the exchange if they aren’t lawfully present in the US.
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.
In Colorado, consumers may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). Nearly 90% of consumers who enrolled in 2022 coverage through their state exchange received premium subsidies.
Coloradans may also find affordable coverage through Medicaid if they’re eligible. See Medicaid eligibility guidelines in Colorado.
The open enrollment period for individual/family health coverage runs from November 1 through January 15 in Colorado (enrollments must be submitted by December 15 in order to have coverage effective January 1).
Outside of open enrollment, a qualifying event is necessary to enroll or make changes to your coverage.
Six insurers participate in the Colorado health insurance marketplace as of 2023:
- Anthem
- Cigna
- Denver Health
- Friday Health Plans
- Kaiser
- Rocky Mountain Health Plans
Insurer participation in Colorado is relatively robust compared with much of the country, but coverage tends to be localized and plan availability is concentrated in urban areas. In many of the state’s rural counties, there are only two insurers offering plans for 2023, although only Jackson County has just a single participating insurer.
For the six insurers that offer individual/family health coverage in Colorado, the average pre-subsidy rate increase was 10.4% for 2023, before any subsidies were applied.
But Colorado also debuted standardized Colorado Option plans for 2023, which have lower premiums and some enhanced benefits, including $0 primary care and mental health care.
The average full-price (pre-subsidy) premium for plans purchased through Connect for Health Colorado in 2022 was about $466/month. That was among the country’s lowest; only Maryland, New Hampshire, and Utah has lower average full-price premiums.
Enrollment in plans through Connect for Health Colorado reached a record high for 2022, with 198,412 people enrolling during the open enrollment period for 2022 coverage. The spike in enrollment was driven in large part by the American Rescue Plan‘s subsidy enhancements. These subsidy enhancements have been extended through 2025 by the Inflation Reduction Act.
Colorado is among the 38 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% of the federal poverty level.
As of August 2022, total enrollment in Medicaid plans and CHIP plans in Colorado stood at more than 1.65 million people, which was 111% 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.
As a result of strong new Colorado 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 in 2019, 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).
As of August 2022, there were 982,696 enrollees in Medicare in Colorado. About 51% of them were enrolled in Original Medicare, with the other 49% enrolled in Medicare Advantage plans instead.
Read more about Medicare in Colorado, including the state’s guaranteed-issue Medigap rules for disabled Medicare beneficiaries, and the one-time enrollment window in 2021 that allowed people with Medigap Plan F or C to switch to a different plan if they chose to do so.
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 Child Health Plan Plus (CHP+)
- Colorado Division of Insurance — Oversees, regulates, and licenses the health insurance companies that offer plans in the state, as well as brokers and agents.
- Colorado Department of Health Care Policy and Financing — Oversees Medicaid and CHP+ in Colorado. Also played a key role in developing the framework for the state’s proposed public option plan, which is likely to be considered by lawmakers in 2021.
- Colorado.gov/Health
- Connect for Health Colorado — The state-run marketplace where individuals and families can compare plan options, enroll in coverage, and receive financial assistance based on their household income. The marketplace is also used for enrollment in Medicaid and CHP+
- Colorado Senior Healthcare/Medicare resources (State Health Insurance Assistance Program) — A local service that provides information and assistance to Medicare beneficiaries and their caregivers.
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.