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(4.5) and (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(4.5) Prior to making any final recommendation pursuant
Page 6, Line 12to subsection (4) of this section regarding plans, coverage, and
Page 6, Line 13the number of eligible slots, the board shall seek input and
Page 6, Line 14recommendations from individuals directly affected by
Page 6, Line 15programs funded by the enterprise and shall discuss any input
Page 6, Line 16and recommendations received at a board meeting held in
Page 6, Line 17accordance with subsection (6) of this section. The board shall
Page 6, Line 18provide opportunities for individuals to provide input and recommendations in English and Spanish.
Page 6, Line 19(7) (a) By February 15, 2026, and by every February 15 thereafter, the board shall prepare a report detailing:
Page 6, Line 20(I) The total revenue received by the enterprise in the previous calendar year;
Page 6, Line 21(II) The share of the total revenue that was received from federal funds;
Page 7, Line 1(III) The share of the total revenue that was received from the fee;
Page 7, Line 2(IV) If any additional amount of the total revenue was
Page 7, Line 3received from any sources other than the federal government
Page 7, Line 4or the fee, the specific source of those revenues and the specific amount of revenues for each source;
Page 7, Line 5(V) Each specific program that received funding from the enterprise;
Page 7, Line 6(VI) Of the total allocation for each program:
Page 7, Line 7(A) The share of the total allocation that was from federal funding; and
Page 7, Line 8(B) The share of the total allocation that was from state funding and the source of that state funding;
Page 7, Line 9(VII) For the reinsurance program, the amount of the actual allocation of state money to the reinsurance program;
Page 7, Line 10(VIII) If less than the maximum allowable allocation of
Page 7, Line 11state money in the fund was allocated to the reinsurance
Page 7, Line 12program, an explanation of why the reinsurance program was not fully funded;
Page 7, Line 13(IX) For any allocation that was made at the discretion
Page 7, Line 14of the board or commissioner and not defined expressly in
Page 7, Line 15statute, an explanation of the allocations, the amount of each
Page 7, Line 16allocation, the rationale for the amounts, and the goals intended to be achieved as a result of each allocation; and
Page 7, Line 17(X) The amount of surplus in the fund, if any, and an
Page 7, Line 18explanation of why the surplus was not allocated to enterprise programs.
Page 8, Line 1(b) By February 28, 2026, and by each February 28 thereafter:
Page 8, Line 2(I) The board shall submit the report to the house of
Page 8, Line 3representatives health and human services committee and the
Page 8, Line 4senate health and human services committee, or their successor committees, and the joint budget committee; and
Page 8, Line 5(II) The division shall post the report on the division's
Page 8, Line 6public-facing website in an easily accessible location and manner.
Page 8, Line 7(c) Notwithstanding the requirement in section 24-1-136
Page 8, Line 8(11)(a)(I), the requirement to submit the report specified in this subsection (7) continues indefinitely.
Page 8, Line 9SECTION 5. In Colorado Revised Statutes, add10-16-1209, 10-16-1210, and 10-16-1211 as follows:
Page 8, Line 1010-16-1209. Repeal of certain provisions - notice to the revisor
Page 8, Line 11- repeal. (1) Sections 10-16-1203 (16), 10-16-1205 (2)(e), and
Page 8, Line 1210-16-1206 (1.5) will take effect only if, by December 31, 2025, the
Page 8, Line 13United States congress does not enact and the president does
Page 8, Line 14not sign federal legislation that extends, recreates, or
Page 8, Line 15otherwise reinstates the enhanced premium tax creditfor the
Page 8, Line 162026 plan year. The commissioner shall notify the revisor of
Page 8, Line 17statutes in writing if the condition specified in this subsection (1)
Page 8, Line 18has occurred by emailing the notice to
Page 8, Line 19revisorofstatutes.ga@coleg.gov. If the condition specified in
Page 8, Line 20this subsection (1) occurs, sections 10-16-1203 (16), 10-16-1205
Page 8, Line 21(2)(e), and 10-16-1206 (1.5) take effect on January 1, 2026.
Page 9, Line 1(2) This section and sections 10-16-1203 (16), 10-16-1205
Page 9, Line 2(2)(e), and 10-16-1206 (1.5) will be repealed if, on or before
Page 9, Line 3December 31, 2025, the United States congress enacts and the
Page 9, Line 4president signs federal legislation that extends, recreates, or
Page 9, Line 5otherwise reinstates the enhanced premium tax credit for the
Page 9, Line 62026 plan year with at least the same eligibility and in the same
Page 9, Line 7amount as authorized by the amendments to the premium tax
Page 9, Line 8credit in the federal "American Rescue Plan Act of 2021", Pub.L.
Page 9, Line 9117-2, and the federal "Inflation Reduction Act of 2022", Pub.L.
Page 9, Line 10117-169, 136 Stat. 1818 (2022). The commissioner shall notify the
Page 9, Line 11revisor of statutes in writing if the condition specified in this
Page 9, Line 12subsection (2) has occurred and of the date on which the
Page 9, Line 13condition occurred by emailing the notice to
Page 9, Line 14revisorofstatutes.ga@coleg.gov. This section and sections
Page 9, Line 1510-16-1203 (16), 10-16-1205 (2)(e), and 10-16-1206 (1.5) are repealed
Page 9, Line 16upon the date identified in the notice that the condition specified
Page 9, Line 17in 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 1810-16-1210. Regulatory agenda - division review of regulation
Page 9, Line 19- repeal. (1) (a) The division shall conduct a review of regulation
Page 9, Line 204-2-76, concerning the health insurance affordability fee
Page 9, Line 21assessment and collection process, codified in 3 CCR 702-4, in
Page 9, Line 22accordance with section 24-4-103.3. The department of
Page 9, Line 23regulatory agencies shall include the division's review of
Page 9, Line 24regulation 4-2-76 in its departmental regulatory agenda that
Page 9, Line 25the department submits to the staff of the legislative council in
Page 9, Line 26accordance with section 2-7-203 (4) by November 1, 2026. The
Page 10, Line 1health and human services committees of the house of
Page 10, Line 2representatives and the senate are the applicable committees of
Page 10, Line 3reference to which the staff of the legislative council shall distribute the review of regulation 4-2-76.
Page 10, Line 4(b) The division shall make a presentation of its review, as
Page 10, Line 5part of the departmental presentations to the committees in
Page 10, Line 6accordance with section 2-7-203, in the 2027 regular legislative session.
Page 10, Line 7(2) This section is repealed, effective July 1, 2027.
Page 10, Line 810-16-1211. Performance audit of the enterprise - repeal.
Page 10, Line 9(1) By December 31, 2027, the state auditor shall complete a
Page 10, Line 10performance audit of the enterprise. In conducting the audit, the state auditor shall:
Page 10, Line 11(a) Determine whether the enterprise and the board are in
Page 10, Line 12compliance with the purpose and responsibilities of the
Page 10, Line 13enterprise and the board as specified in sections 10-16-1202, 10-16-1204, 10-16-1205, and 10-16-1207;
Page 10, Line 14(b) Specify, for each year since the creation of the enterprise:
Page 10, Line 15(I) The annual revenue deposited in the fund from:
Page 10, Line 16(A) The fee collected from carriers pursuant to section 10-16-1205 (1)(a)(I);
Page 10, Line 17(B) The special assessments collected from hospitals pursuant to section 10-16-1205 (1)(a)(II);
Page 10, Line 18(C) Premium tax revenues deposited in the fund pursuant to section 10-3-209 (4)(a)(III) before its repeal on July 1, 2025;
Page 10, Line 19(D) Money allocated to the fund pursuant to section 10-16-1308;
Page 11, Line 1(E) The federal share of the medical assistance payments received pursuant to section 25.5-4-503 (2);
Page 11, Line 2(F) Any revenue collected from revenue bonds pursuant to section 10-16-1204 (1)(b)(II);
Page 11, Line 3(G) Interest and income derived from the deposit and investment of money in the fund; and
Page 11, Line 4(H) Any gifts, grants, or donations received from private or public sources;
Page 11, Line 5(II) The annual expenditures from the fund for the
Page 11, Line 6purposes specified in section 10-16-1205 (1)(b), indicating the
Page 11, Line 7amounts expended in each year for each of the following
Page 11, Line 8purposes and the amount of such expenditures that was paid
Page 11, Line 9from revenues described in subsections (1)(b)(I)(D) and (1)(b)(I)(E) of this section:
Page 11, Line 10(A) To provide funding for the reinsurance program;
Page 11, Line 11(B) To provide payments to carriers to increase the
Page 11, Line 12affordability of health insurance on the individual market for Coloradans who receive the premium tax credit;
Page 11, Line 13(C) To provide subsidies for state-subsidized individual health coverage plans purchased by qualified individuals;
Page 11, Line 14(D) To pay the enterprise's actual administrative costs to implement and administer this part 12; and
Page 11, Line 15(E) To pay the costs of consumer enrollment, outreach, and education activities regarding health-care coverage; and
Page 11, Line 16(III) The amount of revenues allocated or otherwise
Page 11, Line 17designated for a purpose specified in section 10-16-1205 (1)(b) that the enterprise did not encumber or expend;
Page 12, Line 1(c) With regard to the allocation of revenues to the reinsurance program:
Page 12, Line 2(I) Determine, for each year since the enterprise
Page 12, Line 3collected or received revenues, whether the enterprise
Page 12, Line 4allocated to the reinsurance program cash fund the maximum
Page 12, Line 5allowable amount of revenues as specified in section 10-16-1205 (2); and
Page 12, Line 6(II) For any year in which the enterprise did not allocate
Page 12, Line 7the maximum allowable amount of revenues to the reinsurance program, analyze:
Page 12, Line 8(A) The enterprise's and the division's rationale for not
Page 12, Line 9allocating the maximum allowable amount of revenues to the reinsurance program; and
Page 12, Line 10(B) The impact of that decision on the affordability relief
Page 12, Line 11provided to consumers in the individual market and the ability
Page 12, Line 12of the enterprise to fund other programs authorized in this part 12;
Page 12, Line 13(d) Determine whether the enterprise's current and
Page 12, Line 14projected revenues are sufficient for the enterprise to
Page 12, Line 15efficiently and effectively fulfill its duties and responsibilities as specified in this part 12; and
Page 12, Line 16(e) Determine the significance of federal funding on the
Page 12, Line 17ability of the enterprise to efficiently and effectively fulfill its duties and responsibilities as specified in this part 12.
Page 12, Line 18(2) Upon completion of the performance audit required by
Page 12, Line 19subsection (1) of this section, the state auditor shall submit a
Page 13, Line 1written report about the performance audit to the legislative
Page 13, Line 2audit committee and to the health and human services committees of the senate and the house of representatives.
Page 13, Line 3(3) This section is repealed, effective December 31, 2028.
Page 13, Line 4SECTION 6. In Colorado Revised Statutes, 38-13-801, amend (1)(b), (1)(c), and (2)(f); and add (7) as follows:
Page 13, Line 538-13-801. Unclaimed property trust fund - creation -
Page 13, Line 6payments - interest - appropriations - records - rules - repeal.
Page 13, Line 7(1) (b) Except as provided in subsections (2), (3),
andPage 13, Line 8of this section, the principal of the trust fund shall not be expended except
Page 13, Line 9to pay claims made pursuant to this article 13. Money constituting the
Page 13, Line 10principal of the trust fund is not fiscal year spending of the state for
Page 13, Line 11purposes of section 20 of article X of the state constitution and is not subject to appropriation by the general assembly.
Page 13, Line 12(c) Except as provided in
subsection (6)Page 13, Line 13of this section, all interest derived from the deposit and investment of
Page 13, Line 14money in the trust fund shall be credited to the trust fund. Such interest
Page 13, Line 15is not fiscal year spending of the state for purposes of section 20 of article X of the state constitution.
Page 13, Line 16(2) (f) (I) Interest and, if necessary, principal credited, as required
Page 13, Line 17by subsection (6) of this section, as a loan to the provider stabilization
Page 13, Line 18fund created in section 25.5-3-603 (1) does not constitute fiscal year
Page 13, Line 19spending of the state for purposes of section 20 of article X of the state constitution.
Page 13, Line 20(II) Interest and, if necessary, principal credited, as
Page 13, Line 21required by subsection (7) of this section, as a loan to the health
Page 13, Line 22insurance affordability cash fund created in section 10-16-1206
Page 14, Line 1(1) does not constitute fiscal year spending of the state for purposes of section 20 of article X of the state constitution.
Page 14, Line 2(7) (a) (I) Except as provided in subsection (7)(a)(II) of this
Page 14, Line 3section, within ten days after the effective date of this
Page 14, Line 4subsection (7), the state treasurer shall make an interest-free
Page 14, Line 5loan in the amount of one hundred million dollars from interest
Page 14, Line 6derived from the deposit and investment of money in the
Page 14, Line 7unclaimed property trust fund to the health insurance affordability cash fund created in section 10-16-1206 (1).
Page 14, Line 8(II) If there is an insufficient amount of interest in the
Page 14, Line 9unclaimed property trust fund to enable the state treasurer to
Page 14, Line 10credit the full amount of the loan specified in subsection (7)(a)(I)
Page 14, Line 11of this section from interest alone, the state treasurer shall
Page 14, Line 12credit an amount of principal in the trust fund that is sufficient
Page 14, Line 13to enable the state treasurer to credit to the health insurance affordability cash fund the full amount of the loan.
Page 14, Line 14(b) (I) Subsection (7)(a) of this section will take effect
Page 14, Line 15only if, by December 31, 2025, the United States congress does
Page 14, Line 16not enact and the president does not sign federal legislation
Page 14, Line 17that extends, recreates, or otherwise reinstates the enhanced
Page 14, Line 18premium tax credit, as defined in section 10-16-1203 (2.5), for the
Page 14, Line 192026 plan year. The commissioner of insurance shall notify the
Page 14, Line 20revisor of statutes in writing if the condition specified in this
Page 14, Line 21subsection (7)(b)(I) has occurred and of the date on which the
Page 14, Line 22condition occurred by emailing the notice to
Page 14, Line 23revisorofstatutes.ga@coleg.gov. If the condition specified in
Page 14, Line 24this subsection (7)(b)(I) occurs, subsection (7)(a) of this section takes effect on January 1, 2026.
Page 15, Line 1(II) This subsection (7) will be repealed if, on or before
Page 15, Line 2December 31, 2025, the United States congress enacts and the
Page 15, Line 3president signs federal legislation that extends, recreates, or
Page 15, Line 4otherwise reinstates the enhanced premium tax credit, as
Page 15, Line 5defined in section 10-16-1203 (2.5), for the 2026 plan year with at
Page 15, Line 6least the same eligibility and in the same amount as authorized
Page 15, Line 7by the amendments to the premium tax credit, as defined in
Page 15, Line 8section 10-16-1203 (10), in the federal "American Rescue Plan Act
Page 15, Line 9of 2021", Pub.L. 117-2, and the federal "Inflation Reduction Act
Page 15, Line 10of 2022", Pub.L. 117-169, 136 Stat. 1818 (2022). The commissioner
Page 15, Line 11of insurance shall notify the revisor of statutes in writing if the
Page 15, Line 12condition specified in this subsection (7)(b)(II) has occurred and
Page 15, Line 13of the date on which the condition occurred by emailing the
Page 15, Line 14notice to revisorofstatutes.ga@coleg.gov. This subsection (7)
Page 15, Line 15is repealed upon the date identified in the notice that the
Page 15, Line 16condition specified in this subsection (7)(b)(II) occurred or, if the
Page 15, Line 17notice does not specify that date, upon the date of the notice to the revisor of statutes.
Page 15, Line 18SECTION 7. Safety clause. The general assembly finds,
Page 15, Line 19determines, and declares that this act is necessary for the immediate
Page 15, Line 20preservation of the public peace, health, or safety or for appropriations for
Page 15, Line 21the support and maintenance of the departments of the state and state institutions.