Colorado Health Insurance Market Update
Anthem HMO in Colorado announced that it has no intention of withdrawing multiple plans from the individual health insurance market. However, recent accusations regarding the state’s approval rates have led insurers to inform regulators about potential changes.
On August 20, the Colorado Insurance Department revealed that 96,000 individuals would need to find new insurance. Anthem indicated that it might discontinue 62 plans, which would affect approximately 70,000 people, or about two-thirds of its individual market customers. Additionally, Rocky Mountain HMO could discontinue 20 plans, affecting around 26,000 people.
This year, nearly 296,000 individuals in Colorado are enrolled in these market plans. Analysts predict that enrollment will decline next year, particularly with the introduction of increased subsidies as the pandemic situation evolves.
Anthem stated that it had possibly informed about withdrawing certain plans due to the state’s failure to approve rates in August, creating doubts about the financial viability of some plans.
However, Colorado Insurance Commissioner Michael Conway countered that the fees were not typically ready at that time. He noted that the division had instructed insurance companies to finalize their rates by late September, as lawmakers aimed to stabilize the individual markets during a special session that recently concluded.
“The argument from Anthem isn’t accurate,” he remarked.
Lawmakers passed a bill with provisions intended to lessen premium increases, which means that insurers who filed earlier this year might not need to raise rates significantly, as Conway explained.
In Colorado, health insurance companies are required to propose rates for their plans each June, and the department evaluates whether the requested rates will sufficiently stabilize their plans without leading to excessive profits.
Insurers must inform the state by August 19 if they plan to withdraw their plans, although this notification isn’t mandatory. Anthem asserted that it would not actually drop any plans, provided the department approves rates deemed “financially sustainable.” Furthermore, the company stated it won’t exit markets where other options are lacking.
“It’s crucial for Anthem to propose rates that sustainably cover care costs for its members in 2026,” the company added.
Rocky Mountain HMO has not commented on whether it plans to withdraw any of the notified plans.
Projected premium increases for next year stand at 28%.
This week, lawmakers voted to allocate $50 million in federal matching funds, which would translate to about $100 million in cuts for federal funds and an additional $50 million for insurers. Conway noted that this funding would limit the expenses insurance companies are required to cover, consequently affecting the premiums charged to customers. The division estimates that this funding would help reduce the average increase to roughly 19%.
Moreover, an extra $50 million from Congress will assist the state in partially reinstating expired subsidies for clients earning below four times the poverty line, focusing on low-income individuals. The department is still determining how this will impact overall premiums but believes it could encourage over 20,000 individuals to remain in the individual market.
Typically, healthier individuals are the first to drop their coverage when costs rise. Keeping some of these individuals in the market could help mitigate premium increases to a certain degree.
“We’re projecting to see what we can realistically achieve,” he commented.
Initially published: August 29, 2025, 10:54 am MDT
