If you buy health insurance on your own without help from an employer — and without receiving subsidies from the state or federal government — this will come as unwelcome news: Prices for coverage next year will increase by an average of 10% across the state and by even more if you live in the mountains or on the Western Slope.
The state Division of Insurance announced the price increases Tuesday, pinning blame for the rising rates in part on Congress’ refusal to extend some price subsidies last year. Rising healthcare and prescription drug costs are also to blame.
Colorado somewhat made up for the loss of the enhanced subsidies by scraping together funds to pay for its own insurance subsidy. The state credits that with keeping prices from rising even more. Nationwide, the average increase for next year is around 15%.
Prices increased last year by an average of 23% statewide.
Those who are eligible for the state subsidy and the remaining federal subsidies will see their monthly premiums rise by about $20 per month, according to the Division of Insurance. To be eligible for the subsidies, you have to make less than 400% of the federal poverty level, which in 2027 will be $63,840 for a single person and $132,000 for a family of four.
Households that make more than that will likely have to shoulder the full price increase unless they shop around to find a less expensive plan.
“While Congress is pulling the rug out from under millions of Americans struggling to afford healthcare, Colorado is stepping up to save people money,” Gov. Jared Polis said in a statement. “We’re slowing insurance rate increases in the private market well below the national average and saving Coloradans millions of dollars.”
John Ingold, The Colorado Sun
Mesa, mountains hit hardest
Prices will increase more in Mesa County — by 15.5% on average — and across mountain communities — by 11.8% on average. Prices will increase the least on the Eastern Plains, with an average 5.9% increase.
Again, these price hikes apply only to people who shop in what is known as the individual market — i.e., people who don’t get coverage through work and have to buy it separately. Only about 7% of Coloradans buy coverage this way. But, because prices on the individual market are more transparent than other insurance markets, they are often seen as a barometer for broader health insurance trends.
State insurance regulators also have authority to approve prices in the individual market. Insurers this year had asked for an 11% average increase before regulators knocked it down a percentage point.
“We are doing everything we can to keep health insurance prices down so Coloradans can afford access to healthcare,” Colorado Insurance Commissioner Michael Conway said in a statement.
Prices in the small group market, where small companies buy plans for their workers, are expected to increase by an average of 14% in Colorado next year. Prices for larger companies either are approved on a different cycle or are not subject to state regulation.
Adam Fox, the deputy director of the Colorado Consumer Health Initiative, said the price increases are a consequence of federal attacks on the Affordable Care Act, the law that set coverage requirements for many health insurance plans and created the subsidy system. But he said the healthcare industry also deserves some blame.
“We need to take a closer look at the prices that hospitals and pharmaceutical companies are charging, and insurance carriers aren’t doing enough to control costs,” Fox said in a statement. “We must rein in excessive profits in the healthcare industry.”
No disenrollments
The price increases were announced on the same day that Vice President JD Vance said the federal government plans to remove as many as 760,000 Affordable Care Act enrollees from coverage due to suspicion of fraud.
This purge, though, does not appear to affect Colorado. That’s because Colorado operates its own health insurance exchange, Connect for Health Colorado, which acts as a one-stop shopping site for people seeking to buy coverage and sign up for subsidies. Many other states use the federal exchange, Healthcare.gov.
A Connect for Health Colorado spokesperson wrote in an email to The Sun that the exchange “has its own processes to verify eligibility, protect customer information and prevent potentially unauthorized activity. We take marketplace integrity seriously and continue to monitor federal developments.”
Conway, the state insurance commissioner, echoed that in a statement, saying, “What Coloradans should know is that the actions the federal government announced will not impact Coloradans.”
This story previously appeared on The Colorado Sun.
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