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. 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). And overall average rates decreased again in 2021, by 1.4 percent.
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 is under consideration by the legislature.
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 – 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.
Colorado implemented rules to permanently extend its annual open enrollment period to 2.5 months (November 1 to January 15), and a special enrollment period was offered through August 15, 2021 to address the ongoing COVID pandemic and the fact that many Coloradans are newly eligible for premium subsidies (or eligible for increased subsidies) as a result of the American Rescue Plan.
Open enrollment for 2022 medical insurance in Colorado will run from November 1, 2021 through January 15, 2022. 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 2022 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.
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.
Eight insurers participate in the Colorado health insurance marketplace as of 2021, and three of the state’s insurance companies (Oscar, Cigna, and Rocky Mountain Health Plans) expanded their coverage areas as of 2021.
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 10 of the state’s 64 counties, those who shop the state’s exchange have a single carrier option (Anthem Blue Cross/Blue Shield) in 2021 — but that’s down from 22 counties in 2020.
And for 2022, there will only be one county (Jackson) with just a single insurer. Four of the state’s insurers (Bright, Friday, Oscar, and Rocky Mountain HMO) plan to expand their coverage areas, and virtually all Colorado residents will be able to select from at least two insurers during the open enrollment period for 2022 coverage.
Average premiums in Colorado’s individual market dropped by 20% 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 initially proposed an overall average rate increase of just over 2%, but once regulators finalized the rates, the changes for 2021 amounted to an average rate decrease of 1.4%.
For 2022, Colorado’s insurers have proposed another overall average rate increase of 1.4%.
Connect for Health Colorado announced that nearly 180,000 people enrolled in coverage during the open enrollment period for 2021, and that had grown to 212,000 by August 2021, as a result of the COVID/American Rescue Plan enrollment period.
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% of the federal poverty level.
As of late 2020, total enrollment in Medicaid plans and CHIP plans in Colorado stood at more than 1.5 million people, which was 96% 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).
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 allows people with Medigap Plan F or C to switch to a different plan if they choose 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.
- 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.