Source: The Grand Junction Daily Sentinel
Coloradans with individual insurance, commonly known as Obamacare or Affordable Care Act insurance, could be paying double their current premiums by the start of next year.
With open enrollment underway as of today, that reality becomes increasingly likely. However, there are still opportunities to reverse the inflation apparent in the new plan prices.
More than 6,680 Mesa County residents obtained health coverage through the marketplace for 2025.
“Right now, I pay about $450 a month for my insurance plan. I recently learned that my premium could double to about $900 a month … that is $6,000 more per year out of my pocket,” Aubrey Hix, an independently contracted business consultant, said in a press briefing.
“I’m an independent voter. This is not about politics for me.”“I don’t care if you have a D or an R next to your name, because I have neither. I care about if you’re voting to reduce my costs or not. I care about if you’re looking out for me.”
ARE THE NEW PRICES PERMANENT?
National Public Radio reported that the current government shutdown stemmed from Senate Democrats’ refusal to approve the continued government funding resolution that passed the House, primarily because it did not extend the credits set to expire by the end of this year.
If a tax credit extension is included in the continuing resolution, the spike in individual insurance premiums would see more than an 80% reduction.
When the shutdown started on Oct. 1, Democratic lawmakers intended to obtain that extension before November, when official prices would become available and enrollees could select their coverage for 2026.
Anna Cubel, who supervises Hilltop’s local enrollment assistance program (Health Access) for Obamacare, Medicaid and the Child Health Plan Plus, said it would have been ideal if the decision were made before open enrollment, but it isn’t a hard cut-off.
What are individual insurance plans?
All individual market plans in the state are offered through “Connect for Health Colorado,” which was established after the Affordable Care Act went into effect more than 10 years ago.
At its core, the marketplace makes it easier for individuals and small businesses to compare and purchase private health insurance plans. The premium tax credit launched alongside the state marketplaces to subsidize costs for eligible individuals and families.
Initially, the credit was accessible to anyone who lawfully resided in the country, made an adjusted gross income between 100% and 400% of the federal poverty level, was not eligible for public coverage like Medicaid and did not have affordable, employer-based coverage.
In 2021, the Biden administration’s American Rescue Plan Act implemented the enhanced premium tax credits, expanding eligibility to enrollees making more than 400% of the federal poverty level and reducing the maximum household contribution.
Soon after, Biden’s Inflation Reduction Act prolonged those credits through the end of 2025.
KFF Health reported that the number of people signing up for health insurance had more than doubled since the premium tax credits began.
“If they (Congress) do decide to extend them in one facet or another, we’ll be able to reach out to our clients and have them come back in,” Cubel said. “It means a little bit more work for us, but that’s OK. This is our time to shine.”
She added that clients wouldn’t have to take action to receive the credits retroactively, but it’s advised that they review their options with the new prices to ensure they receive the highest-quality plan they can afford.
While Hilltop Health Access can provide such updates to clients, they don’t work with enrollees who select plans on their own or with insurance brokers.
Those who are not connected to Health Access should keep their eye on the news and the marketplace website to ensure they are up-to-date. Those interested in connecting with Health Access can receive walk-in assistance at various Mesa County Libraries locations through the first week of November:
Nov. 3 – Clifton Library, 9 a.m. to 5:30 p.m.
Nov. 4 – Palisade Library, 9 a.m. to noon and 2 p.m. to 6 p.m.
Nov. 5 – Central Library, 9 a.m. to 4 p.m.
Nov. 7 – Fruita Library, 9 a.m. to 2 p.m.
“We’re that one-stop shop for health care coverage — especially financially assisted health care coverage, either through Connect for Health or through the state of Colorado,” Cubel said. “But we’re not employed by either entity, so we’re not biased in any way. We’re just here to help people.”
Colorado also made a one-time extension to its marketplace enrollment period this year, allowing residents to enroll as late as Jan. 15 (with coverage going into effect February). If enrollees select a plan before the usual deadline, Dec. 15, their coverage starts with the new year.
HOW LIKELY IS AN EXTENSION?
As of publication, with the shutdown still underway, there’s no clear indication from Congress on which direction it will take.
But there are two most likely outcomes: Democrats concede to reopening the government without an extension, or Republicans agree to include an extension in the continued funding resolution. Either choice would likely be due to mounting pressure over frozen federal programs and federal employees going unpaid.
House Representative Jeff Hurd, R-D3, said he has heard from many Mesa County residents and constituents across his district about the importance of these tax credits in keeping healthcare affordable.
Although not a permanent solution, Hurd said he is open to extending the credit by at least a year, but not through the continued funding resolution required to reopen the government.
“Their condition of reopening the government is that we need to pass the enhanced premium tax credits,” Hurd said. “We cannot hold the government hostage because of a policy issue. It’s wrong when Republicans did it, and it’s now wrong when Democrats are doing it.”
“…we need to extend the enhanced premium tax credits, temporarily, to help alleviate the immediate issue of skyrocketing health insurance premiums,” he added. “But fundamentally, the enhanced premium tax credits are just addressing the symptom, which is a healthcare system that is extremely expensive.”
He added that he is already on a bill that would extend the credits through the end of the year, but it cannot pass until the government re-opens.
That bill, the Bipartisan Premium Tax Credit Extension Act, was introduced into the House nearly one month before the shutdown began, where it has yet to pass since being referred to a House committee. It currently boasts 28 co-sponsors, 14 Democrats and 14 Republicans.
Many of Colorado’s Democratic members of Congress, however, said that the bill is simply “kicking the can down the road,” and will put the legislature (and enrollees) in the same predicament next year.
House Rep. Jason Crow, CD-6, and Sen. John Hickenlooper both told the Sentinel they believe the best solution is a permanent extension of the credits, adding that Republicans maintain full control of Congress and the White House, yet refuse to discuss any compromise.
“Working families deserve real relief, not a bill that puts a temporary (bandage) on the problem for a year and then causes health care premiums to soar again,” Crow said.
“Republicans must come back from their vacations, do their jobs and work with Democrats to pass a budget that reopens the government and lowers health care costs,” he added.
Hickenlooper’s office added that the bill permanently extending the enhanced premium tax credits is already in the Senate, whereas there is no guarantee that the one-year extension bill would make it past the House when the government reopens.
