Source: Denver Business Journal
Moves by two health insurance carriers to withdraw some of their plans from Colorado could soon be reversed thanks to fresh state legislation that addresses some of the financial hardship faced by carriers next year, the state’s insurance commissioner said.
Colorado Gov. Jared Polis on Thursday signed into law House Bill 25-1006, which seeks to lower health insurance premiums next year by devoting more funding to pay for the state’s highest health care claims.
The legislation, passed in special session, came up as those in Colorado’s health care industry forecast a major industry disruption due to the expiration of federal tax credits that helped insurers keep their rates lower. The credits, which were established through the Affordable Care Act, are set to expire at the end of the year unless Congress takes action to renew them.
Colorado’s health care leaders said that up to 100,000 people would opt out of participating in the state’s individual insurance exchange as a result. Carriers proposed significantly higher rate increases for 2026, at an average of 28%, in part to make up for the gap in tax credits, according to industry experts.
The state’s recent legislative action could bring the number of people who opt out of the exchange down from 100,000 to about 75,000, Colorado Insurance Commissioner Michael Conway told the Denver Business Journal. The law will boost funding for premium assistance in Colorado to $75 million, up from having about $25 million for premium assistance, Conway said.
Keeping 25,000 people on the individual exchange could be enough to get two health insurers to change their minds about withdrawing some of their Colorado health plans and coverage, Conway said. More people covered by insurance means an improved risk pool, which puts downward pressure on rates, he said.
Anthem HMO and Rocky Mountain HMO filed plans last week to withdraw coverage or plans from multiple areas of the state that would affect a total of 96,000 people.
Anthem said in a statement posted to its website that it will only offer those plans if Colorado allows it to set “financially sustainable rates” for its individual health plans. The insurer in July proposed an average 33.6% rate increase for individual health plans next year.
Anthem said that it was forced to file to withdraw the plans because the state’s Division of Insurance (DOI) said it may not approve rates until Sept. 30 this year.
“The delay of approved rates can cause uncertainty for 2026 planning purposes,” Anthem said.
Conway said that the delay in review was to allow state lawmakers the opportunity to pass H.B. 1006, which could affect carriers’ rate increase proposals. All carriers were advised well ahead of time about the potential delay, he said.
Anthem’s HMO Colorado originally filed to discontinue 21 plans and withdraw 41 plans from certain counties, ending coverage for 70,000 members — about two-thirds of its current total enrollment, according to previous reporting.
“We hope to withdraw this notification and offer plans in as many regions as possible once the state rate review is complete,” Anthem said in an emailed statement.
The carrier noted that it will still offer some kind of coverage in all Colorado communities; the withdrawals, if they happen, would only apply to individual plans on the exchange — not health plans offered through employers.
Conway said he is hopeful that having more premium assistance will also motivate Rocky Mountain HMO to change course on its plan to withdraw some local coverage. He said the insurer cited uncertainty in the industry as a whole as a reason to discontinue coverage, but that premium assistance might be enough incentive.
Anthem is the sole carrier that placed pressure on the DOI to approve its rate filings by saying that it will be forced to discontinue health plans if rates are not approved, Conway said.
“We need a partnership in that, not somebody that’s going to try and hold our rate review process over our head in this way,” Conway said.
Anthem on its website said that its proposed rates are based on health care services it expects its members to access next year and the associated costs.
