Medical Updates:
In a significant development, the enhanced ACA subsidies in Colorado's individual health-insurance marketplace, which were implemented during the pandemic, are due to expire on December 31, 2025. This decision could potentially lead to a 28% increase in premiums for individual health plans in 2026, according to recent reports [1][3].
Adam Fox, the deputy director of the Colorado Consumer Health Initiative, has confirmed the expiration of these subsidies, stating that they will cease on December 31 [2]. The anticipated surge in premiums is primarily due to the expiration of these higher federal subsidies [3][4].
The potential premium hike is primarily attributed to Congress’s failure to extend the enhanced ACA tax credits, or subsidies, which has forced insurers to raise rates due to a shrinking and less healthy risk pool [1][3][4]. In response, Colorado officials, including Insurance Commissioner Michael Conway, are examining options to mitigate the impacts. One key approach under consideration involves legislation to empower the Health Insurance Affordability Enterprise—the state entity that manages exchange subsidies and the reinsurance program—to increase fees on insurance premiums by up to 1% (in addition to the existing 2% fee) [2].
However, a similar bill failed earlier this year amid concerns about increased costs for consumers. Advocates expect this proposal to return in a future special or regular legislative session as a potential solution to partially offset the federal subsidy cuts [2].
Governor Jared Polis has publicly blamed Congressional Republicans for this "chaos" in the federal health insurance markets that is driving up rates. While the federal government has not yet reinstated or extended the enhanced subsidies, Colorado is hoping to find state-level remedies to reduce the premium increases, though options are limited without federal action [4].
Open enrollment for Colorado's individual health-insurance marketplace is nearing. As the situation remains under active public review, with proposed insurer rates open for comment through August 8, 2025 [1], there is still a chance for Congress to act and potentially reduce the 28% spike in premiums for next year.
- The expiration of the enhanced ACA subsidies in Colorado's individual health-insurance marketplace could lead to a significant increase in premiums for health plans in 2026, prompting the state to consider legislation to mitigate the impacts.
- The Health Insurance Affordability Enterprise, a state entity that manages exchange subsidies and the reinsurance program in Colorado, is being considered to increase fees on insurance premiums by up to 1% to help offset the potential premium hike.
- In response to the anticipated surge in premiums, Colorado officials, including Insurance Commissioner Michael Conway, are examining state-level remedies to reduce the premium increases, minimizing the impact on mental health, fitness-and-exercise, nutrition, and therapies-and-treatments, key components of workplace-wellness and health-and-wellness.
- While Congressional Republicans have been criticized for causing "chaos" in the federal health insurance markets, resulting in driving up rates, there is still a chance for Congress to act and potentially reduce the 28% spike in premiums for next year, affecting Medicare and individual health plans.
- As open enrollment for Colorado's individual health-insurance marketplace nears, advocates are urging Congress to take action to extend the enhanced ACA subsidies, ensuring affordable healthcare options for individuals, families, and businesses and promoting a strong, healthy workforce.
