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.
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, (1)(b)(II), and (2)(d)(I) introductory
Page 2, Line 9portion; and add (1)(a.5), (1)(b)(VI), (1)(b)(VII), (2)(d)(IV), and (2)(e) as follows:
Page 2, Line 1010-16-1205. Health insurance affordability fee - special
Page 2, Line 11assessment on hospitals - allocation of revenues. (1) (a) (I) Starting in
Page 2, Line 12the 2021 calendar year, the enterprise shall assess and collect from
Page 3, Line 1carriers, by July 15 each year, a health insurance affordability fee. Except
Page 3, Line 2as provided in subsection (1)(a.5) of this section, the fee amount is
Page 3, Line 3based on the following percentages of premiums collected by the
Page 3, Line 4following carriers in the immediately preceding calendar year on health benefit plans issued in the state:
Page 3, Line 5(a.5) (I) Starting in the 2026 calendar year, the
Page 3, Line 6commissioner may increase the health insurance affordability
Page 3, Line 7fee by up to one percentage point above the percentages specified in subsection (1)(a)(I) of this section.
Page 3, Line 8(II) In determining whether to increase the percentage of
Page 3, Line 9premiums collected by the carriers pursuant to subsection
Page 3, Line 10(1)(a)(I) of this section, the commissioner shall consider the following objectives:
Page 3, Line 11(A) Maintaining the enterprise programs to achieve a
Page 3, Line 12statewide average twenty percent premium reduction in the
Page 3, Line 13reinsurance program, providing subsidies for individuals with an
Page 3, Line 14income of up to two hundred fifty percent of the federal poverty
Page 3, Line 15line who purchase insurance on the exchange, and providing
Page 3, Line 16coverage for qualified individuals at the 2025 calendar year enrollment level;
Page 3, Line 17(B) Covering the costs of ensuring compliance in the
Page 3, Line 18individual market with the federal Hyde amendment or a similar amendment; and
Page 3, Line 19(C) Supporting additional affordability efforts to maintain or increase coverage in the individual market.
Page 3, Line 20(III) The commissioner shall notify carriers of the health
Page 3, Line 21insurance fee amount for the calendar year not later than
Page 4, Line 1August 31 of the year before the calendar year for which the fee amount is assessed.
Page 4, Line 2(b) The enterprise shall use the fee, the special assessment on
Page 4, Line 3hospitals, and any other money available in the fund as follows, allocated in accordance with subsection (2) of this section:
Page 4, Line 4(II) To provide payments to carriers to increase the affordability
Page 4, Line 5of health insurance on the individual market for Coloradans who
receive the premium tax creditPage 4, Line 6(VI) To cover the costs of ensuring compliance in the
Page 4, Line 7individual market with the federal Hyde amendment or a similar amendment; and
Page 4, Line 8(VII) To support additional affordability efforts to maintain or increase coverage in the individual market.
Page 4, Line 9(2) (d) (I) The enterprise shall allocate the revenues collected in
Page 4, Line 102023
and each year thereafterPage 4, Line 11deposited in the fund in 2023
and each year thereafterPage 4, Line 12(IV) For the 2025 and 2026 calendar years, the enterprise
Page 4, Line 13may use a portion of the revenues collected in 2025 and 2026 for
Page 4, Line 14the purposes specified in subsections (1)(b)(VI) and (1)(b)(VII) of this section.
Page 4, Line 15(e) The enterprise shall allocate the revenues assessed
Page 4, Line 16for the 2026 calendar year and for each calendar year
Page 4, Line 17thereafter, and any other money deposited in the fund in 2026 and each year thereafter, in the following way:
Page 4, Line 18(I) Up to forty percent for subsidies for state-subsidized
Page 4, Line 19individual health coverage plans purchased by qualified individuals;
Page 5, Line 1(II) Up to forty percent to the reinsurance program cash fund;
Page 5, Line 2(III) Up to ten percent to reduce the costs of individual
Page 5, Line 3health plans for individuals who purchase an individual health benefit plan on the exchange;
Page 5, Line 4(IV) Up to three and one-half percent for actual
Page 5, Line 5administrative costs as set forth in subsection (1)(b)(IV) of this section; and
Page 5, Line 6(V) Up to six and one-half percent, and any money
Page 5, Line 7remaining after the allocations are made in this subsection(2)(e), that the commissioner may designate for:
Page 5, Line 8(A) Any allocation specified in this subsection (2)(e); or
Page 5, Line 9(B) New and emerging health insurance affordability
Page 5, Line 10initiatives, including the purposes specified in subsections
Page 5, Line 11(1)(b)(VI) and (1)(b)(VII) of this section and health insurance affordability cash fund reserves.
Page 5, Line 12SECTION 3. In Colorado Revised Statutes, 10-16-1206, amend (1)(f) and (1)(g); and add (1)(h) as follows:
Page 5, Line 1310-16-1206. Health insurance affordability cash fund -
Page 5, Line 14creation - repeal. (1) There is created in the state treasury the health insurance affordability cash fund. The fund consists of:
Page 5, Line 15(f) All interest and income derived from the deposit and investment of money in the fund;
andPage 5, Line 16(g) The federal share of the medical assistance payments received pursuant to section 25.5-4-503 (2); and
Page 5, Line 17(h) Gifts, grants, or donations received from private or
Page 6, Line 1public sources for the operation, reserves, and sustainability of the enterprise.
Page 6, Line 2SECTION 4. In Colorado Revised Statutes, 10-16-1207, add (4)(e) as follows:
Page 6, Line 310-16-1207. Health insurance affordability board - creation -
Page 6, Line 4membership - powers and duties - subject to open meetings and
Page 6, Line 5public records laws - commissioner rules. (4) The board is authorized to:
Page 6, Line 6(e) Seek, accept, and expend gifts, grants, or donations
Page 6, Line 7from private or public sources for the operation, reserves, and
Page 6, Line 8sustainability of the enterprise. The enterprise shall consider
Page 6, Line 9the feasibility of allocating gifts, grants, or donations received
Page 6, Line 10from specific localities or directed to specific localities to be used only in those localities.
Page 6, Line 11SECTION 5. Safety clause. The general assembly finds,
Page 6, Line 12determines, and declares that this act is necessary for the immediate
Page 6, Line 13preservation of the public peace, health, or safety or for appropriations for
Page 6, Line 14the support and maintenance of the departments of the state and state institutions.