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Colorado Health Insurance Exchange Explained

By Andrea Davidson


The Colorado Health Insurance Exchange is officially known as Connect for Health Colorado (CHC). This is a new healthcare marketplace that enables previously uninsured individuals and small businesses to get insured at affordable rates. CHC will start enrolling customers starting Oct 2013, and coverage for those who are newly insured will begin no later than Jan 1, 2014.

CHC was established as one a compliance requirement for states under the Affordable Care Act or PPACA, which is perhaps better known as the healthcare reform bill. The law requires all legal residents and citizens residing in the United States to be provided health insurance starting from 2014. The exchanges being established in individual states are among the core components of the reform.

In Colorado, the exchange will bring another 500,000 people into the fold as being eligible for coverage. This eliminates a huge chunk of the state's 750,000 or so currently uninsured residents. Individuals who already have coverage but want to jump to a better plan can use the exchange to shop around and compare plans.

CHC currently has two core components or areas of operation. One is the marketplace that is to be used by individuals, and the other one is for small businesses that have less than 100 employees. The latter platform, called SHOP, may be opened up to larger businesses with more than 100 workers after 2017, subject to the state approving implementation of this second phase too.

Colorado expects healthcare premiums to drop by 14 to 20 percent due to the reform measures. Some of it is attributed to the influx of new customers, coupled with the establishment of the exchange where providers are going to be forced to compete for customers. Forecasts show that the premium amount paid by a family in the state will drop by anywhere in between $1,510 to $2,160 per year.

The best part about this whole reform plan is that it transforms some of the worst rules in the old system. For example, providers participating in the exchange cannot turn away customers with preexisting conditions or charge them higher premiums than others. They also cannot refuse to cover a preexisting condition if it is normally covered under the plan for everyone else.

The federal government is funding the establishment of CHC, and will pay 100% of all operational cost until 2016. Starting from 2017, the state will pay 5% of costs. From 2020 onwards, the state must shell out 20% of CHC's operational costs. All said and done, Colorado is in line to get more than $12 billion in additional federal funding to help with the implementation of this exchange and other reforms.

There has never been such an expansion of the government-aided social net since the New Deal was implemented. There have been protests about healthcare in the country being socialized, and business groups have been vocal about the additional costs they must face. There's also the possibility that confusion over the proposed changes coupled with implementation problems may cause the transition to be painful. However, what matters most is that the Colorado Health Insurance Exchange ensures that a majority of those previously uninsured will be covered going forward.




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