Source: Denver Business Journal
Two health insurance carriers will not end some of their coverage in parts of Colorado following a $100 million effort to help the industry with anticipated financial woes.
Anthem HMO and Rocky Mountain HMO reversed course from plans they filed in August to withdraw coverage or plans in multiple parts of the state, the Colorado Division of Insurance announced Tuesday.
The move would have meant about 96,000 Coloradans who enroll for health insurance through the state’s public insurance exchange would have needed to look for a new health plan next year, the DOI said.
The change follows a new law passed by Colorado lawmakers in August that aims to address a major disruption in the health insurance industry 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.
The legislation devotes $100 million, raised through the sale of state tax credits, to help subsidize carriers on the individual exchange and pay for the highest health care claims if Congress takes no action.
A total of about 300,000 Coloradans get their insurance through individual market plans on the exchange, and close to 225,000 depend on the enhanced federal tax credits to afford health coverage in the individual market, according to the DOI.
If Congress does not extend the tax credits, most Coloradans enrolled in the individual market will see their premiums “skyrocket” next year, and tens of thousands of Coloradans will lose coverage, Colorado Insurance Commissioner Michael Conway said in a statement.
“If Congress doesn’t act, the pain will be unspeakable,” Conway said.
Earlier this year, health insurance carriers in Colorado proposed significantly higher rate increases for 2026, at an average of 28% compared to rates around 10% for the past two years. Much of the rise was attributed to the anticipated gap in tax credits, but premiums are also rising due to the rising cost and increased use of health care, higher prescription drug costs and labor market pressures, industry experts say.
Anthem’s HMO Colorado plan had 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, the DOI said. Rocky Mountain HMO filed plans to withdraw 20 plans from certain counties, affecting 26,000 people.
The impacted Colorado counties for both carriers included major metropolitan areas such as Denver, Douglas, Adams, Arapahoe and Broomfield.
After filing plans to withdraw some coverage, Anthem said in a statement posted to its website that it could only continue to offer the plans it did in 2025 if Colorado allowed 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 DOI said it may not approve rates until Sept. 30 this year, causing uncertainty for planning purposes in 2026.
Conway said in a previous interview that the delay in review was to allow state lawmakers the opportunity to pass the law that offers support to carriers, which would likely affect carriers’ rate increase proposals. All carriers were advised well ahead of time about the potential delay, he said.
Conway also forecast that both Anthem and Rocky Mountain would reconsider their withdrawals with passage of the state law. While uncertainty in the industry as a whole was a reason to discontinue coverage, premium assistance offered a good incentive, he said.
In a statement to the Denver Business Journal on Tuesday, Anthem spokesperson Emily Snooks said the carrier is “committed to Colorado and will continue offering an individual health plan in every county in 2026.”
“We value our partnership with the Division of Insurance and our shared commitment to offering rates that ensure all Coloradans have continued access to high-quality health care,” Snooks said.
