A Bill for an Act
Page 1, Line 101Concerning modifications to the Colorado health insurance
Page 1, Line 102affordability enterprise to address the affordability
Page 1, Line 103of health insurance in the individual market using
Page 1, Line 104nonappropriated funding sources.
Bill Summary
(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)
The bill makes the following changes to the "Health Insurance Affordability Act":
- If the federal enhanced premium tax credit is not extended on or before December 31, 2025, authorizes an interest-free loan from the unclaimed property trust fund to the health insurance affordability cash fund and allocates the loan proceeds:
- To the reinsurance program;
- To carriers to increase the affordability of health plans on the individual market for individuals who purchase individual health benefit plans on the Colorado health benefit exchange and receive the premium tax credit authorized under federal law (state-based insurance subsidies); and
- For other programs administered by the Colorado health insurance affordability enterprise (enterprise);
- Of the revenues collected by the enterprise before the effective date of the bill that had been allocated for state-based insurance subsidies, allows the enterprise to reallocate any unexpended amount to other programs the enterprise administers;
- Requires the health insurance affordability board (board) to prepare an annual report detailing certain financial information about the enterprise; and
- Directs the board to make recommendations to the commissioner of insurance regarding coverage and plan design of state-subsidized plans to maximize plan enrollment.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. In Colorado Revised Statutes, 10-16-1203, add (2.5) and (16) as follows:
Page 2, Line 310-16-1203. Definitions. As used in this part 12, unless the context otherwise requires:
Page 2, Line 4(2.5) "Enhanced premium tax credit" means the premium
Page 2, Line 5tax credit, as amended by the federal "American Rescue Plan
Page 2, Line 6Act of 2021", Pub.L. 117-2, and the federal "Inflation Reduction
Page 2, Line 7Act of 2022", Pub.L. 117-169, 136 Stat. 1818 (2022), which expanded
Page 2, Line 8eligibility for and the amount of the premium tax credit.
Page 3, Line 1(16) (a) "Unclaimed property trust fund" means the unclaimed property trust fund created in section 38-13-801 (1).
Page 3, Line 2(b) This subsection (16) takes effect on January 1, 2026, only if the condition specified in section 10-16-1209 (1) occurs.
Page 3, Line 3SECTION 2. In Colorado Revised Statutes, 10-16-1205, amend (2)(d)(I) introductory portion; and add (2)(d)(IV) and (2)(e) as follows:
Page 3, Line 410-16-1205. Health insurance affordability fees - special
Page 3, Line 5assessment on hospitals - allocation of revenues. (2) (d) (I) Except as
Page 3, Line 6provided in subsections (2)(d)(IV) and (2)(e) of this section, the
Page 3, Line 7enterprise shall allocate the revenues collected in 2023 and each year
Page 3, Line 8thereafter, and any other money deposited in the fund in 2023 and each year thereafter, in the following amounts and order of priority:
Page 3, Line 9(IV) On or after the effective date of this subsection
Page 3, Line 10(2)(d)(IV), the enterprise shall reallocate any amount of
Page 3, Line 11revenues collected and allocated pursuant to subsection
Page 3, Line 12(2)(d)(I) of this section that have not been expended on or before
Page 3, Line 13the effective date of this subsection (2)(d)(IV), not to exceed
Page 3, Line 14twenty million dollars, for any other purpose specified in
Page 3, Line 15subsection (2)(d)(I) of this section except administrative costs described in subsection (2)(d)(I)(A) of this section.
Page 3, Line 16(e) (I) On or after the date on which the state treasurer
Page 3, Line 17credits money to the fund in accordance with section 10-16-1206
Page 3, Line 18(1.5)(a), except as provided in subsection (2)(e)(II) of this section,
Page 3, Line 19the enterprise shall allocate the money credited to the fund pursuant to section 10-16-1206 (1.5)(a) as follows:
Page 3, Line 20(A) Up to fifty million dollars to the reinsurance
Page 3, Line 21program cash fund; and
Page 4, Line 1(B) Up to fifty million dollars to carriers to reduce the
Page 4, Line 2costs of individual health plans for individuals who purchase an
Page 4, Line 3individual health benefit plan on the exchange and receive the premium tax credit.
Page 4, Line 4(II) The enterprise may allocate up to five million dollars
Page 4, Line 5of the money credited to the fund in accordance with section
Page 4, Line 610-16-1206 (1.5)(a) for any other purpose specified in subsection
Page 4, Line 7(2)(d)(I) of this section except administrative costs described in subsection (2)(d)(I)(A) of this section.
Page 4, Line 8(III) This subsection (2)(e) takes effect on January 1, 2026, only if the condition specified in section 10-16-1209 (1) occurs.
Page 4, Line 9SECTION 3. In Colorado Revised Statutes, 10-16-1206, add (1.5) as follows:
Page 4, Line 1010-16-1206. Health insurance affordability cash fund -
Page 4, Line 11creation. (1.5) (a) (I) The fund also consists of one hundred
Page 4, Line 12million dollars credited to the fund as a loan from the
Page 4, Line 13unclaimed property trust fund pursuant to section 38-13-801(7)(a).
Page 4, Line 14(II) Money credited to the fund pursuant to section
Page 4, Line 1538-13-801 (7)(a) is an interest-free loan from the unclaimed
Page 4, Line 16property trust fund to the fund. The enterprise may accept and
Page 4, Line 17expend the money so credited as specified in section 10-16-1205
Page 4, Line 18(2)(e) and shall repay the loan received pursuant to section 38-13-801 (7)(a) no later than January 1, 2045.
Page 4, Line 19(III) A loan made from the unclaimed property trust fund to a separate fund in the enterprise:
Page 4, Line 20(A) Is an interfund loan according to governmental
Page 5, Line 1accounting standards board codification 1800.102, meaning that
Page 5, Line 2the loan is not classified as revenue and is booked as an interfund receivable or payable; and
Page 5, Line 3(B) Is not state fiscal year spending, as defined in section
Page 5, Line 424-77-102 (17), or state revenues, as defined in section 24-77-103.6
Page 5, Line 5(6)(c), and does not count against either the state fiscal year
Page 5, Line 6spending limit imposed by section 20 of article X of the state
Page 5, Line 7constitution or the excess state revenues cap, as defined in section 24-77-103.6 (6)(b)(I)(G).
Page 5, Line 8(IV) Loan liabilities that are recorded in the fund but
Page 5, Line 9that are not required to be paid in the current state fiscal year
Page 5, Line 10shall not be considered when calculating sufficient statutory fund balance for purposes of section 24-75-109.
Page 5, Line 11(b) This subsection (1.5) takes effect on January 1, 2026, only if the condition specified in section 10-16-1209 (1) occurs.
Page 5, Line 12SECTION 4. In Colorado Revised Statutes, 10-16-1207, amend (4)(c.5)(III); and add (7) as follows:
Page 5, Line 1310-16-1207. Health insurance affordability board - creation -
Page 5, Line 14membership - powers and duties - subject to open meetings and
Page 5, Line 15public records laws - annual report - commissioner rules. (4) The board is authorized to:
Page 5, Line 16(c.5) Further recommend, for approval and establishment by the
Page 5, Line 17commissioner by rule, additional parameters for implementing the
Page 5, Line 18subsidies for state-subsidized individual health coverage plans authorized
Page 5, Line 19by this part 12, including that the coverage required pursuant to state-subsidized individual health coverage plans must:
Page 5, Line 20(III) For a person who, at the time the person applies for
Page 6, Line 1state-subsidized coverage, meets the income requirements to qualify for
Page 6, Line 2emergency medical assistance pursuant to section 25.5-5-103 and who is
Page 6, Line 3a qualified individual who meets the eligibility criteria established in rule
Page 6, Line 4pursuant to subsection (4)(c)(IV) of this section, include coverage and plan design that:
Page 6, Line 5
(A) Has no premium;Page 6, Line 6
(B)Has an actuarial value of not less than ninety-four percentPage 6, Line 7
(C)Page 6, Line 8cost sharing
that is further reduced from subsection (4)(c.5)(III)(B) of thisPage 6, Line 9
sectionPage 6, Line 10emergency services equivalent to cost-sharing responsibilities for emergency medical assistance pursuant to section 25.5-5-103;
Page 6, Line 11(7) (a) By February 15, 2026, and by every February 15 thereafter, the board shall prepare a report detailing:
Page 6, Line 12(I) The total revenue received by the enterprise in the previous calendar year;
Page 6, Line 13(II) The share of the total revenue that was received from federal funds;
Page 6, Line 14(III) The share of the total revenue that was received from the fee;
Page 6, Line 15(IV) If any additional amount of the total revenue was
Page 6, Line 16received from any sources other than the federal government
Page 6, Line 17or the fee, the specific source of those revenues and the specific amount of revenues for each source;
Page 6, Line 18(V) Each specific program that received funding from the
Page 6, Line 19enterprise;
(VI) Of the total allocation for each program:
Page 7, Line 1(A) The share of the total allocation that was from federal funding; and
Page 7, Line 2(B) The share of the total allocation that was from state funding and the source of that state funding;
Page 7, Line 3(VII) For the reinsurance program, the amount of the actual allocation of state money to the reinsurance program;
Page 7, Line 4(VIII) If less than the maximum allowable allocation of
Page 7, Line 5state money in the fund was allocated to the reinsurance
Page 7, Line 6program, an explanation of why the reinsurance program was not fully funded;
Page 7, Line 7(IX) For any allocation that was made at the discretion
Page 7, Line 8of the board or commissioner and not defined expressly in
Page 7, Line 9statute, an explanation of the allocations, the amount of each
Page 7, Line 10allocation, the rationale for the amounts, and the goals intended to be achieved as a result of each allocation; and
Page 7, Line 11(X) The amount of surplus in the fund, if any, and an
Page 7, Line 12explanation of why the surplus was not allocated to enterprise programs.
Page 7, Line 13(b) By February 28, 2026, and by each February 28 thereafter:
Page 7, Line 14(I) The board shall submit the report to the house of
Page 7, Line 15representatives health and human services committee and the
Page 7, Line 16senate health and human services committee, or their successor committees, and the joint budget committee; and
Page 7, Line 17(II) The division shall post the report on the division's
Page 7, Line 18public-facing website in an easily accessible location and manner.
Page 8, Line 1(c) Notwithstanding the requirement in section 24-1-136
Page 8, Line 2(11)(a)(I), the requirement to submit the report specified in this subsection (7) continues indefinitely.
Page 8, Line 3SECTION 5. In Colorado Revised Statutes, add 10-16-1209 as follows:
Page 8, Line 410-16-1209. Repeal of certain provisions - notice to the revisor
Page 8, Line 5- repeal. (1) Sections 10-16-1203 (16), 10-16-1205 (2)(e), and
Page 8, Line 610-16-1206 (1.5) will take effect only if, by December 31, 2025, the
Page 8, Line 7United States congress does not enact and the president does
Page 8, Line 8not sign federal legislation that extends, recreates, or
Page 8, Line 9otherwise reinstates the enhanced premium tax credit beyond
Page 8, Line 10the 2025 calendar year. The commissioner shall notify the
Page 8, Line 11revisor of statutes in writing if the condition specified in this
Page 8, Line 12subsection (1) has occurred by emailing the notice to
Page 8, Line 13revisorofstatutes.ga@coleg.gov. If the condition specified in
Page 8, Line 14this subsection (1) occurs, sections 10-16-1203 (16), 10-16-1205(2)(e), and 10-16-1206 (1.5) take effect on January 1, 2026.
Page 8, Line 15(2) This section and sections 10-16-1203 (16), 10-16-1205
Page 8, Line 16(2)(e), and 10-16-1206 (1.5) will be repealed if, on or before
Page 8, Line 17December 31, 2025, the United States congress enacts and the
Page 8, Line 18president signs federal legislation that extends, recreates, or
Page 8, Line 19otherwise reinstates the enhanced premium tax credit beyond
Page 8, Line 20December 31, 2025, with at least the same eligibility and in the
Page 8, Line 21same amount as authorized by the amendments to the premium
Page 8, Line 22tax credit in the federal "American Rescue Plan Act of 2021",
Page 8, Line 23Pub.L. 117-2, and the federal "Inflation Reduction Act of 2022",
Page 9, Line 1Pub.L. 117-169, 136 Stat. 1818 (2022). The commissioner shall
Page 9, Line 2notify the revisor of statutes in writing if the condition
Page 9, Line 3specified in this subsection (2) has occurred and of the date on
Page 9, Line 4which the condition occurred by emailing the notice to
Page 9, Line 5revisorofstatutes.ga@coleg.gov. This section and sections
Page 9, Line 610-16-1203 (16), 10-16-1205 (2)(e), and 10-16-1206 (1.5) are repealed
Page 9, Line 7upon the date identified in the notice that the condition specified
Page 9, Line 8in this subsection (2) occurred or, if the notice does not specify that date, upon the date of the notice to the revisor of statutes.
Page 9, Line 9SECTION 6. In Colorado Revised Statutes, 38-13-801, amend (1)(b), (1)(c), and (2)(f); and add (7) as follows:
Page 9, Line 1038-13-801. Unclaimed property trust fund - creation -
Page 9, Line 11payments - interest - appropriations - records - rules - repeal.
Page 9, Line 12(1) (b) Except as provided in subsections (2), (3),
andPage 9, Line 13of this section, the principal of the trust fund shall not be expended except
Page 9, Line 14to pay claims made pursuant to this article 13. Money constituting the
Page 9, Line 15principal of the trust fund is not fiscal year spending of the state for
Page 9, Line 16purposes of section 20 of article X of the state constitution and is not subject to appropriation by the general assembly.
Page 9, Line 17(c) Except as provided in
subsection (6)Page 9, Line 18of this section, all interest derived from the deposit and investment of
Page 9, Line 19money in the trust fund shall be credited to the trust fund. Such interest
Page 9, Line 20is not fiscal year spending of the state for purposes of section 20 of article X of the state constitution.
Page 9, Line 21(2) (f) (I) Interest and, if necessary, principal credited, as required
Page 9, Line 22by subsection (6) of this section, as a loan to the provider stabilization
Page 9, Line 23fund created in section 25.5-3-603 (1) does not constitute fiscal year
Page 10, Line 1spending of the state for purposes of section 20 of article X of the state constitution.
Page 10, Line 2(II) Interest and, if necessary, principal credited, as
Page 10, Line 3required by subsection (7) of this section, as a loan to the health
Page 10, Line 4insurance affordability cash fund created in section 10-16-1206
Page 10, Line 5(1) does not constitute fiscal year spending of the state for purposes of section 20 of article X of the state constitution.
Page 10, Line 6(7) (a) (I) Except as provided in subsection (7)(a)(II) of this
Page 10, Line 7section, within ten days after the effective date of this
Page 10, Line 8subsection (7), the state treasurer shall make an interest-free
Page 10, Line 9loan in the amount of one hundred million dollars from interest
Page 10, Line 10derived from the deposit and investment of money in the
Page 10, Line 11unclaimed property trust fund to the health insurance affordability cash fund created in section 10-16-1206 (1).
Page 10, Line 12(II) If there is an insufficient amount of interest in the
Page 10, Line 13unclaimed property trust fund to enable the state treasurer to
Page 10, Line 14credit the full amount of the loan specified in subsection (7)(a)(I)
Page 10, Line 15of this section from interest alone, the state treasurer shall
Page 10, Line 16credit an amount of principal in the trust fund that is sufficient
Page 10, Line 17to enable the state treasurer to credit to the health insurance affordability cash fund the full amount of the loan.
Page 10, Line 18(b) (I) Subsection (7)(a) of this section will take effect
Page 10, Line 19only if, by December 31, 2025, the United States congress does
Page 10, Line 20not enact and the president does not sign federal legislation
Page 10, Line 21that extends, recreates, or otherwise reinstates the enhanced
Page 10, Line 22premium tax credit, as defined in section 10-16-1203 (2.5), beyond
Page 10, Line 23the 2025 calendar year. The commissioner shall notify the
Page 11, Line 1revisor of statutes in writing if the condition specified in this
Page 11, Line 2subsection (7)(b)(I) has occurred and of the date on which the
Page 11, Line 3condition occurred by emailing the notice to
Page 11, Line 4revisorofstatutes.ga@coleg.gov. If the condition specified in
Page 11, Line 5this subsection (7)(b)(I) occurs, subsection (7)(a) of this section takes effect on January 1, 2026.
Page 11, Line 6(II) This subsection (7) will be repealed if, on or before
Page 11, Line 7December 31, 2025, the United States congress enacts and the
Page 11, Line 8president signs federal legislation that extends, recreates, or
Page 11, Line 9otherwise reinstates the enhanced premium tax credit, as
Page 11, Line 10defined in section 10-16-1203 (2.5), beyond December 31, 2025, with
Page 11, Line 11at least the same eligibility and in the same amount as
Page 11, Line 12authorized by the amendments to the premium tax credit, as
Page 11, Line 13defined in section 10-16-1203 (10), in the federal "American
Page 11, Line 14Rescue Plan Act of 2021", Pub.L. 117-2, and the federal "Inflation
Page 11, Line 15Reduction Act of 2022", Pub.L. 117-169, 136 Stat. 1818 (2022). The
Page 11, Line 16commissioner shall notify the revisor of statutes in writing if
Page 11, Line 17the condition specified in this subsection (7)(b)(II) has occurred
Page 11, Line 18and of the date on which the condition occurred by emailing the
Page 11, Line 19notice to revisorofstatutes.ga@coleg.gov. This subsection (7)
Page 11, Line 20is repealed upon the date identified in the notice that the
Page 11, Line 21condition specified in this subsection (7)(b)(II) occurred or, if the
Page 11, Line 22notice does not specify that date, upon the date of the notice to the revisor of statutes.
Page 11, Line 23SECTION 7. Safety clause. The general assembly finds,
Page 11, Line 24determines, and declares that this act is necessary for the immediate
Page 11, Line 25preservation of the public peace, health, or safety or for appropriations for
Page 12, Line 1the support and maintenance of the departments of the state and state institutions.