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Less than two weeks from now, Colorado residents looking to buy health insurance through the state’s individual marketplace will be able to choose plans, but they can’t yet see how severe the price increases they face will be. Typically, Connect for Health Colorado has a window-shopping period before open enrollment begins Nov. 1. This year has been anything but typical, however, as enhanced subsidies that make marketplace coverage more affordable are poised to expire and Congress has failed to give a definitive answer on extending them. Lawmakers increased the subsidies during the pandemic to make insurance less expensive, leading to an increase in marketplace enrollment. The government shutdown that began Oct. 1 largely reflected a disagreement about health care policy. Democrats want to see the subsidies extended before they’ll vote for a temporary budget. Republicans say the government must reopen before dealing with the subsidies, which leaders said they would consider extending, but only with changes. All the while, the leaves fall and the Halloween aisle gets picked over, and the time for families to choose their insurance draws closer. On Monday, Colorado Insurance Commissioner Michael Conway warned that premiums for plans on the individual marketplace could rise 160% next year, with the hardest-hit households facing a $22,000 increase in their annual costs to maintain coverage. Open enrollment has been messy every year, but those increases would be an “abject disaster,” he said at a news conference Monday. The Colorado Division of Insurance has required companies that sell on the state marketplace to submit two sets of rates: one if the subsidies expire at the end of the year, and one if Congress extends them. Insurers submitted rates this summer, before the legislature passed a bill during the special session to try to blunt the increases. The division then asked them to submit again, after calculating the impact of that change. Nationwide, the “sticker price” of marketplace plans is increasing about 18%, with about 8% due to the expiring tax credits and 10% due to rises in the amount and cost of care people need, said Justin Giovannelli, project director of the Center on Health Insurance Reforms at Georgetown University. At the same time, the share of the sticker price that people have to pay is also increasing, so the average out-of-pocket cost will more than double, he said. “We have gross premiums going up, we have the help they’re receiving (to pay the premiums) going down,” he said in a press briefing Monday. Congress could, theoretically, extend the subsidies at any point before the new plan year starts Jan. 1, or perhaps even beyond, if legislation made them retroactive. That wouldn’t undo the increases from insurers expecting a sicker risk pool, because they expect healthier people won’t pay the higher premiums, though. Also, there’s no guarantee that people who determined coverage was too expensive when they shopped in November would look again if Congress acted later. The state could make changes after Nov. 1 if Congress acted, though that isn’t ideal, said Kevin Patterson, CEO of Connect for Health Colorado. “Will it be clunky? I would imagine so, because we are normally done with this work in September,” he said Monday. “We just have to be prepared to make the change as quickly as we can, and try to communicate to our constituents, once we have an answer, how do we tell them what they need to do and what those steps are.” Sign up for our weekly newsletter to get health news sent straight to your inbox.
