Source: The Daily Sentinel
The cost of health insurance for more than 42,000 people in western Colorado is set to skyrocket next year, according to the insurance division of Colorado’s Department of Regulatory Agencies.
This year’s filings for state marketplace plans, commonly known as Obamacare, indicate that monthly premiums in Grand Junction and across western Colorado will rise by more than 38%.
If those proposals are approved, a 45-year-old in western Colorado will pay approximately $2,760 more for their insurance over the course of 2026 than they will this year. For a 60-year-old in the same region, that figure is just over $5,000.
“Premium increases hitting over 300,000 Coloradans means many will have to choose between access to health care and groceries, between access to health care and school supplies, between access to health care and paying their mortgage,” Colorado Insurance Commissioner Michael Conway said.
To see how much your premiums could rise, visit KFF Health’s estimate tool.
It isn’t uncommon for insurance premiums to rise annually, but the statewide average of 28% is notably higher than the increase in years past: 5.6% in 2025, 9.7% in 2024, 10.4% in 2023 and 1.1% in 2022.
Rocky Mountain Health Plans, which requested the largest premium increase of all insurers statewide (36.4%), declined to comment on its reasoning for the spike.
Colorado Insurance Commissioner Michael Conway has overseen the regulation of Colorado’s insurance industry since 2018.
FEDERAL POLICY A PRIMARY FACTOR
According to Conway, the increase is mainly due to Congress not extending the soon-to-expire expanded premium tax credits.
“It’s going to hit the mountain areas, the rural counties and the Western Slope the hardest, with average increases approaching 40%,” he added. “The sad reality is that many of those folks will be forced to gamble with their health because they simply cannot afford these rate increases caused by the federal government.”
The standard, premium tax credits will remain available to residents making under 400% of the federal poverty level, $62,600 for a single person or $128,600 for a family of four. Still, costs will rise across the board because of the ripple effects of higher premiums for those who lose eligibility.
The main effect is that people in good health could decide that coverage isn’t worth the higher premiums and opt out of the marketplace. KFF Health reported that in 2023, 63% of uninsured adults (ages 18-64) said they were uninsured because the cost was too high.
With fewer healthy enrollees, the plans have a higher concentration of people who require insurance because of chronic conditions or expensive prescriptions.
Essentially, insurance agencies are requesting higher premiums in anticipation of a market with fewer healthy, low-cost enrollees to offset losses from covering a similar number of chronically ill enrollees.
Explaining the marketplace, tax credits
All individual market plans in the state are offered through “Connect for Health Colorado,” which every state has been required to offer since 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.
KFF Health reported that the number of people signing up for health insurance had more than doubled since the premium tax credits were introduced.
“Despite this, we will continue doing all that we can to increase access and save people money, but it’s really hard to do when what Congress is doing is leading to huge increases in the cost of health care nationally,” Colorado Gov. Jared Polis said.
Another consequence of those credits expiring will be an estimated $100 million reduction in funding for the state’s reinsurance program.
The program uses a pool of state dollars and “pass-through” funds (money the state has saved for the federal government) to pay some of the higher-cost claims on behalf of insurance companies. So, insurers have fewer expenses that high premiums would otherwise offset, making lower premiums possible.
According to the Colorado Division of Insurance, the loss of funding will reduce the program’s “impact” in 2026 by about 40%. The division attributed just over a quarter of the upcoming increase to the program’s shrinking.
Congress can still renew the enhanced premium tax credits, technically, through the end of this year. However, continuing the credits won’t reverse the higher premiums unless it is done before Aug. 13, the deadline for insurance companies to file their final ACA rates.
“Colorado families are already struggling to make ends meet. Republicans must act now,” said U.S. Sen. Bennet (D-Colo).
Republican U.S. House Rep. Jeff Hurd, who represents western Colorado under the state’s 3rd Congressional District, did not respond to a request for comment on the premiums rising or whether he would consider prolonging the tax credits.
Congressman Jeff Hurd speaks at the 2025 Club 20 Spring Conference at the Grand Junction Convention Center on April 26. Tuesday night in a town hall peaking at more than 7,000 listeners, Hurd fielded questions from constituents over the course of an hour on numerous topics — including public lands, Medicaid and immigration reform.
While agreeing that legislators are most culpable for these impacts, Primary Care Partners Executive Director Michael Pramenko added that many apolitical factors contribute to premium increases every year.
According to him, a notable cause of the high costs is the healthcare system’s focus on treating chronic diseases with expensive drugs instead of preventing them in the first place.
The Washington Post reported in April that annual spending on GLP-1 drugs (like Ozempic and Wegovy) increased from $13.7 billion in 2018 to $71.7 billion in 2023.
“We decided it’s OK for these industries to sell their sugar and sell their alcohol, and then we try to treat the (resulting) diseases with extraordinarily expensive drugs,” Pramenko said. “And we wonder why we’re paying so much for health care in the United States. We all own part of this.”
IMPACTS COULD EXTEND PAST MARKETPLACE
Aside from the financial burden to marketplace participants, Conway and Pramenko predicted that the rise in premiums will worsen enrollee health care outcomes and exacerbate the cost of all other insurance plans.
Most people with a severe, chronic disease will pay whatever price they can for insurance; however, some of those people simply won’t be able to.
Regardless, they still need care, and if it becomes deadly, hospitals are required to treat them.
“Will they take care of their chronic disease? Probably not, they can’t afford it,” Pramenko said. “They will all wait until they need the emergency room for something that ends up costing everybody more. If they can’t pay their hospital bills, the hospitals make it up by charging the people with insurance more.”
Alternatively, individuals without a chronic disease might opt against paying the new cost of marketplace coverage and delay care until it’s absolutely necessary.
The healthier population won’t immediately end up in the emergency room, barring any substantial accident or health emergency, but they won’t end up in the primary care office either.
Neglecting those routine check-ups and avoiding outpatient care could cause long-term health issues that would have been less severe or non-existent if they were addressed years prior during an annual physical.
“Now, people are being told by Congress, ‘Don’t get sick, because if you do, you might be out of luck,’” Pramenko said.
