Congressional Inaction Leads to An Average Doubling of Health Insurance Costs for 225,000 Hardworking Coloradans

Congressional failure to extend the enhanced premium tax credits will lead to an estimated 225,000 Coloradans seeing an average 101% increase in health insurance premiums

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), today released the final approved premium information on private health insurance plans for 2026 for the individual market (for people who don't get coverage from an employer plan). These filings have been reviewed and updated to reflect the passage of HB25B-1006, which blunted some of the premium increases.

The vast majority of consumers enrolled in Colorado's individual marketplace, Connect for Health Colorado, will see a statewide approximate net average premium increase of 101%, meaning a doubling of their premium costs. The DOI estimates these premium increases will lead to approximately 75,000 Coloradans losing access to health coverage.

These premium increases reflect the failure of Congressional Republicans to extend the enhanced premium tax credits in time for Open Enrollment. Federal enhanced premium tax credits (ePTCs) have lowered costs to Americans since 2021. The tax credits are scheduled to expire on December 31, 2025. Approximately 225,000 Coloradans depend on the tax credits to afford health coverage in the individual market. The loss of these tax credits represents the vast majority of the premium increases consumers will see as they shop around during open enrollment.

The premium increases that Coloradans will be forced to pay if Congress continues to fail to help them will be staggering. For example, a family of four with an annual income of approximately $128,000 will no longer qualify for any financial assistance if the ePTCs are not extended. In that scenario, that family will see their health insurance premium bill increase by approximately $14,000 for a standard silver plan if they happen to live in the Denver metro area. If that family of four lives on the Western Slope, Grand Junction, southwest Colorado, the San Luis Valley, or the eastern plains, they will see a premium increase of over $16,000 to nearly $21,000 for that standard silver level plan.

If Congress extended the enhanced premium tax credits, the premium increase would be reduced by more than 80%. Instead of receiving a premium increase of 101%, the average premium increase for those 225,000 Coloradans would be 16%, and some customers would not pay a premium increase at all.

"These premium increases are going to create impossible decisions for families across the state. We have sounded the alarm bells at every turn, but Congress' refusal to act means that Coloradans will be left with unacceptably high health insurance bills during a tightening time in the economy," said Colorado Insurance Commissioner Michael Conway. "I thank the Colorado legislature for what they have done so far to protect their constituents, and I urge Congress to step up and extend the enhanced premium tax credits. Coloradans shouldn't have to gamble their health simply because they cannot afford these rate increases caused by the federal government."

Passage of HB25B-1006 During Colorado's Special Legislative Session Saves Consumers $220 Million

The passage of HB25B-1006 during this summer's special legislative session is greatly reducing health insurance costs for Coloradans. The bill will save Coloradans $220 million dollars on health insurance next year and is reducing the statewide average net premium increase they will see from 174% (as previously announced) to 101%. It is also expected to keep 28,000 more Coloradans insured.

HB25B-1006 provides funding for the Health Insurance Affordability Enterprise to deliver premium subsidies and fully fund Colorado's reinsurance program. The premium subsidies directly reduce premium costs for consumers, ultimately saving financially assisted consumers $75 million on their premiums. Funding provided by HB25B-1006 also stabilizes Colorado's reinsurance program, giving insurance companies the certainty they need to file premiums that are lower than they could achieve without the legislation.

Impact Summary of HB25B-1006

Open Enrollment is still expected to begin on November 1. Connect for Health Colorado will be sending out renewal notices to customers this week. As consumers shop around, the Division wants to remind them of Colorado Option plans, which will continue to provide plans with $0 primary care and mental health visits.

The following table shows the percentage saved on premiums by rating area from the reinsurance program:

Since 2020, the reinsurance program has reduced premiums for Coloradans. The approved rate filings show that the program will save Coloradans 21.3% on their premiums. The reinsurance program reimburses at different levels in different parts of the state with a three-tiered structure designed to provide more assistance to the rural and mountain areas that have higher health care costs and higher health insurance premiums than other areas. This spreads risk across the Colorado health insurance market, reducing the impact of high-cost claims. Reinsurance thereby lowers premiums for individuals and makes it easier for people to afford coverage.

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