The Colorado Option registration count has arrived.  But the debate over the Jared Polis-backed insurance plan is far from over.

The Colorado Option registration count has arrived. But the debate over the Jared Polis-backed insurance plan is far from over.

About 35,000 people signed up for a Colorado Option health insurance plan in the program’s first year, Gov. Jared Polis announced Tuesday during his state of the state address.

The figure includes about 25,000 people who signed up for a Colorado Option plan through the state’s Connect for Health Colorado shopping exchange. Another 10,000 people signed up through OmniSalud, a new program offering state-subsidized insurance plans to people who don’t have immigration documents and are therefore not eligible for federal subsidies available on the main portal. Connect for Health.

The number provides some of the first data to show whether the program, in the works for nearly two years and a major health policy initiative for Polis and legislative Democrats, is succeeding. But, as you might expect, interpretations of the number were widely shared on Tuesday.

Polis touted the figure as “exceeding initial enrollment goals,” and Colorado Insurance Commissioner Michael Conway said in a statement that enrollment “significantly exceeded my hopes of what we would achieve over the course of our first year.

The Colorado option is an insurance plan designed by the state and sold by private insurance companies, which both reap the reward if it is profitable and bear the risk if it is not. This is essentially Colorado’s market-based solution to creating a public health insurance option. Colorado Option plans are currently only available in the Small Group and Individual markets. These are the places where, respectively, small businesses purchase plans for their workers and where people who are not covered through an employer seek coverage themselves.

The Colorado option is intended to provide better than normal coverage and is to be sold at below average prices, although critics question whether it has been successful on both fronts.

Exceed expectations

Through Jan. 10, more than 192,000 people had signed up for a health plan through Connect for Health, according to the exchange. Open registration ended on January 15 and the final number of open registrations is not yet available, which means that the number of registrations for the Colorado option and the total number could increase further. But right now, Colorado option listings make up about 13% of the total listings on the main exchange.

Although the state has never released an expected number for enrollment in the Colorado option, Vince Plymell, a spokesman for the state’s insurance division, said the agency internally hopes about 5 % to 7% of total registrations, which means the actual number is about double what they say they expect.

“Perhaps I shouldn’t be surprised,” Conway said in his statement. “Not only do these plans create more competition in our insurance market, they provide better value to Coloradans, with many services that lead to better health outcomes offered free or at low cost.”

For advocacy groups that support the Colorado option, the numbers demonstrate the value the plans bring to the marketplace.

“It shouldn’t be surprising that Colorado beat national trends with our CO Option insurance underwriting because we gave people what they said they wanted,” said Jake Williams, CEO of Healthier Colorado, in a statement.

Critics push back

But for opponents of the Colorado option, the enrollment numbers show the plans simply weren’t attracting many people, despite the state’s efforts to favor the Colorado option in the market.

The website for Connect for Health Colorado, the state’s health insurance exchange, featured in October 2018. (Eric Lubbers, The Colorado Sun)

The state originally listed Colorado Option plans first in search results on Connect for Health. For people whose existing health insurance company exited the market, the state automatically paired them with a suggested Colorado option plan, with more work required if they wanted to choose something else. The only plans available through OmniSalud were the Colorado Option plans.

And, while the state said customers could collectively save $14.7 million by choosing the cheapest Colorado Option plan available to them rather than automatically renewing their existing plan, Colorado Option plans were often not not the cheapest available to consumers.

“Most Coloradans have agreed that a non-standard private insurance plan works best for them,” Brandon Arnold, associate director of the Colorado Association of Health Plans, said in a statement.

“More than 87% of Colorado residents find better value from Colorado health insurance providers, but efforts that could save people money on health care, such as reducing the burden regulation, have been lacking.”

This point is echoed by many insurance brokers – people who help consumers buy insurance plans. Meagan Fearing, president of the Colorado State Association of Health Underwriters, a group of brokers, said Colorado option plans were often not the best fit for the consumers she and other brokers worked with. This made her wonder if the program was worth it.

“I would say the numbers are a bit higher than expected,” Fearing said. “But I would also say it’s disappointing that we’ve gone through all of this for a fraction of our state’s population.”

Bigger fights to come

While there aren’t any plans to have legislation to change the Colorado option significantly this session — at least none with a realistic chance of passing — the health insurance wars will likely remain hot in 2023.

This is the first year the Division of Insurance has had the authority to summon carriers for a public hearing if their Colorado option prices are not low enough. (Insurance companies are required to sell the Colorado option at progressively lower prices for the first three years of the program – falling to 15% below 2021 rates in 2025, after adjusting for inflation. )

These hearings, in turn, could lead to unprecedented regulatory action by the state government, including the ability to tell hospitals how much they can charge for a service, in order to lower the prices of the option. Colorado.

For health reform advocates, the hearings are when the benefits of the Colorado Option program really start to kick in. And the regulatory authority on display at these hearings will make the Colorado option even more attractive to consumers next year.

“Some members of our health care system have tried to avoid accountability,” Adam Fox, deputy director of the Colorado Consumer Health Initiative, which supports the Colorado Option, said in a statement. “With this increased transparency, we will ensure the industry meets the demands Coloradans deserve, which will make Colorado Option plans much more effective next year.”

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