A Bill for an Act
Page 1, Line 101Concerning updates to the health insurance affordability
Page 1, Line 102enterprise to provide continuing coverage for health
Page 1, Line 103insurance needs in the state.
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.)
Beginning in 2026, the bill authorizes an increase to the health insurance affordability fee assessed and collected from insurance carriers (carriers) by up to one percentage point to implement and administer the health insurance affordability enterprise (HIAE). The bill includes objectives for the commissioner of insurance (commissioner) to consider in determining whether to increase the HIAE fee, including, in part, maintaining HIAE programs to achieve a premium reduction in the reinsurance program and to provide subsidies for individuals with low income who purchase insurance on the Colorado health benefit exchange. The commissioner shall notify carriers of the amount of the HIAE fee for the upcoming calendar year.
The bill changes the allocation of the HIAE fee assessed for 2026, dedicating up to 40% each to state-subsidized individual health coverage plans purchased by qualified individuals and to the reinsurance program cash fund, with the remaining revenue allocated for other purposes specified in the bill, including new and emerging health insurance affordability initiatives.
The bill authorizes the enterprise to seek, accept, and expend gifts, grants, or donations for the purposes of the HIAE.
This Unofficial Version Includes Committee
Amendments Not Yet Adopted on Second Reading
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, amend (12)(c) as follows:
Page 2, Line 310-16-1203. Definitions. As used in this part 12, unless the context otherwise requires:
Page 2, Line 4(12) "Qualified individual" means an individual, regardless of immigration status, who:
Page 2, Line 5(c) Is not eligible for the premium tax credit, medicaid, medicare,
Page 2, Line 6or the children's basic health plan; except for an individual who is eligible pursuant to section 25.5-5-201 (6) or 25.5-8-109 (7).
Page 2, Line 7SECTION 2. In Colorado Revised Statutes, 10-16-1205, amend
Page 2, Line 8(1)(a)(I) introductory portion and (2)(d)(I) introductory portion; and add (1)(a.5), (1)(b)(VI), (1)(b)(VII), (2)(d)(IV), (2)(e), and (6) as follows:
Page 2, Line 910-16-1205. Health insurance affordability fee - special
Page 2, Line 10assessment on hospitals - allocation of revenues - report on revenue
Page 2, Line 11and expenditures. (1) (a) (I) Starting in the 2021 calendar year, the
Page 2, Line 12enterprise shall assess and collect from carriers, by July 15 each year, a
Page 3, Line 1health insurance affordability fee. Except as provided in subsection
Page 3, Line 2(1)(a.5) of this section, the fee amount is based on the following
Page 3, Line 3percentages of premiums collected by the following carriers in the
Page 3, Line 4immediately preceding calendar year on health benefit plans issued in the state:
Page 3, Line 5(a.5) (I) Starting in the 2026 calendar year, if the federal
Page 3, Line 6government discontinues or decreases the enhanced federal
Page 3, Line 7"Patient Protection and Affordable Care Act" subsidies created
Page 3, Line 8by the federal "American Rescue Plan Act of 2021", Pub.L. 117-2,
Page 3, Line 9and extended by the federal "Inflation Reduction Act of 2022",
Page 3, Line 10Pub.L. 117-169, 136 Stat. 1818 (2022), or money is otherwise
Page 3, Line 11insufficient, the enterprise may increase the health insurance
Page 3, Line 12affordability fee by up to one percentage point above the
Page 3, Line 13percentages specified in subsection (1)(a)(I) of this section to the extent necessary to:
Page 3, Line 14(A) Maintain the enterprise programs to achieve a
Page 3, Line 15statewide average twenty percent premium reduction in the
Page 3, Line 16reinsurance program, provide subsidies for individuals who
Page 3, Line 17purchase insurance on the exchange at the 2026 subsidy levels
Page 3, Line 18recommended by the board in 2025, and provide coverage for
Page 3, Line 19qualified individuals at the 2025 calendar year enrollment level;
Page 3, Line 20(B) Cover the costs of ensuring compliance in the
Page 3, Line 21individual market with the federal Hyde amendment or a similar amendment; and
Page 3, Line 22(C) Cover the costs of ensuring that Coloradans have
Page 3, Line 23access to legally protected health-care activity, as defined in section 12-30-121 (1)(d).
Page 4, Line 1(II) The commissioner shall notify carriers of the health
Page 4, Line 2insurance fee amount for the calendar year not later than
Page 4, Line 3August 31, 2025, for the 2026 assessment and, for subsequent
Page 4, Line 4years, not later than June 1 of the year before the calendar year for which the fee amount is assessed.
Page 4, Line 5(b) The enterprise shall use the fee, the special assessment on
Page 4, Line 6hospitals, and any other money available in the fund as follows, allocated in accordance with subsection (2) of this section:
Page 4, Line 8(VI) To cover the costs of ensuring compliance in the
Page 4, Line 9individual market with the federal Hyde amendment or a similar amendment; and
Page 4, Line 10(VII) To cover the costs of ensuring Coloradans have
Page 4, Line 11access to legally protected health-care activities, as defined in section 12-30-121 (1)(d).
Page 4, Line 12(2) (d) (I) The enterprise shall allocate the revenues collected in
Page 4, Line 132023
and each year thereafterPage 4, Line 14deposited in the fund in 2023
and each year thereafterPage 4, Line 15(IV) For the 2025 and 2026 calendar years, the enterprise
Page 4, Line 16may use a portion of the revenues collected in 2025 and 2026 for
Page 4, Line 17the purposes specified in subsections (1)(b)(VI) and (1)(b)(VII) of this section.
Page 4, Line 18(e) The enterprise shall allocate the revenues assessed
Page 4, Line 19for the 2026 calendar year and for each calendar year
Page 4, Line 20thereafter, and any other money deposited in the fund in 2026 and each year thereafter, in the following way:
Page 5, Line 1(I) Up to forty percent for subsidies for state-subsidized
Page 5, Line 2individual health coverage plans purchased by qualified individuals;
Page 5, Line 3(II) Up to forty percent to the reinsurance program cash fund;
Page 5, Line 4(III) Up to ten percent to reduce the costs of individual
Page 5, Line 5health plans for individuals who receive premium tax credits on the exchange;
Page 5, Line 6(IV) Up to three and one-half percent for actual
Page 5, Line 7administrative costs as set forth in subsection (1)(b)(IV) of this section; and
Page 5, Line 8(V) Up to six and one-half percent, and any money
Page 5, Line 9remaining after the allocations are made in this subsection(2)(e), that the commissioner may designate for:
Page 5, Line 10(A) Any allocation specified in this subsection (2)(e); or
Page 5, Line 11(B) New and emerging health insurance affordability
Page 5, Line 12initiatives, including the purposes specified in subsections
Page 5, Line 13(1)(b)(VI) and (1)(b)(VII) of this section and health insurance affordability cash fund reserves.
Page 5, Line 14(6) Beginning January 15, 2026, and not later than
Page 5, Line 15January 15 each year thereafter, the commissioner shall report
Page 5, Line 16annually to the board and to the house of representatives
Page 5, Line 17health and human services committee and the senate health and
Page 5, Line 18human services committee, or their successor committees, and to
Page 5, Line 19the joint budget committee concerning the revenue and
Page 5, Line 20expenditures of the enterprise, by enterprise program.
Page 6, Line 1SECTION 3. In Colorado Revised Statutes, 10-16-1206, amend (1)(f) and (1)(g); and add (1)(h) as follows:
Page 6, Line 210-16-1206. Health insurance affordability cash fund -
Page 6, Line 3creation - repeal. (1) There is created in the state treasury the health insurance affordability cash fund. The fund consists of:
Page 6, Line 4(f) All interest and income derived from the deposit and investment of money in the fund;
andPage 6, Line 5(g) The federal share of the medical assistance payments received pursuant to section 25.5-4-503 (2); and
Page 6, Line 6(h) Gifts, grants, or donations received from private or
Page 6, Line 7public sources for the operation, reserves, and sustainability of the enterprise.
Page 6, Line 8SECTION 4. In Colorado Revised Statutes, 10-16-1207, add (4)(e) and (4.5) as follows:
Page 6, Line 910-16-1207. Health insurance affordability board - creation -
Page 6, Line 10membership - powers and duties - subject to open meetings and
Page 6, Line 11public records laws - commissioner rules. (4) The board is authorized to:
Page 6, Line 12(e) Seek, accept, and expend gifts, grants, or donations
Page 6, Line 13from private or public sources for the operation, reserves, and
Page 6, Line 14sustainability of the enterprise. The enterprise shall consider
Page 6, Line 15the feasibility of allocating gifts, grants, or donations received
Page 6, Line 16from specific localities or directed to specific localities to be used only in those localities.
Page 6, Line 17(4.5) At least annually, the board shall seek formal input
Page 6, Line 18from individuals directly impacted by programs funded by the
Page 6, Line 19enterprise in order to understand the impact of the programs and opportunities for improvement of the programs.
Page 7, Line 1SECTION 5. Safety clause. The general assembly finds,
Page 7, Line 2determines, and declares that this act is necessary for the immediate
Page 7, Line 3preservation of the public peace, health, or safety or for appropriations for
Page 7, Line 4the support and maintenance of the departments of the state and state institutions.