First Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 25-0887.01 Brita Darling x2241
HOUSE BILL 25-1297
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING UPDATES TO THE HE ALTH INSURANCE AFFORDABILITY101
ENTERPRISE TO PROVIDE CONT INUING COVERAGE FOR HEALTH102
INSURANCE NEEDS IN THE STATE .103
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
HOUSE SPONSORSHIP
Brown and Gilchrist,
SENATE SPONSORSHIP
Jodeh,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. 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.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 10-16-1203, amend2
(12)(c) as follows:3
10-16-1203. Definitions. As used in this part 12, unless the4
context otherwise requires:5
(12) "Qualified individual" means an individual, regardless of6
immigration status, who:7
(c) Is not eligible for the premium tax credit, medicaid, medicare,8
or the children's basic health plan;
EXCEPT FOR AN INDIVIDUAL WHO IS9
ELIGIBLE PURSUANT TO SECTION 25.5-5-201 (6) OR 25.5-8-109 (7).10
SECTION 2. In Colorado Revised Statutes, 10-16-1205, amend11
(1)(a)(I) introductory portion, (1)(b)(II), and (2)(d)(I) introductory12
portion; and add (1)(a.5), (1)(b)(VI), (1)(b)(VII), (2)(d)(IV), and (2)(e)13
as follows:14
10-16-1205. Health insurance affordability fee - special15
assessment on hospitals - allocation of revenues. (1) (a) (I) Starting in16
the 2021 calendar year, the enterprise shall assess and collect from17
HB25-1297-2- carriers, by July 15 each year, a health insurance affordability fee. EXCEPT1
AS PROVIDED IN SUBSECTION (1)(a.5) OF THIS SECTION, the fee amount is2
based on the following percentages of premiums collected by the3
following carriers in the immediately preceding calendar year on health4
benefit plans issued in the state:5
(a.5) (I) S
TARTING IN THE 2026 CALENDAR YEAR , THE6
COMMISSIONER MAY INCREASE THE HEALTH INSURANCE AFFORDABILITY7
FEE BY UP TO ONE PERCENTAGE POINT ABOVE THE PERCENTAGES SPECIFIED8
IN SUBSECTION (1)(a)(I) OF THIS SECTION.9
(II) I
N DETERMINING WHETHER TO INCREASE THE PERCENTAGE OF10
PREMIUMS COLLECTED BY THE CARRIERS PURSUANT TO SUBSECTION11
(1)(a)(I)
OF THIS SECTION, THE COMMISSIONER SHALL CONSIDER THE12
FOLLOWING OBJECTIVES:13
(A) M
AINTAINING THE ENTERPRISE PROGRAMS TO ACHIEVE A14
STATEWIDE AVERAGE TWENTY PERCENT PREMIUM REDUCTION IN THE15
REINSURANCE PROGRAM, PROVIDING SUBSIDIES FOR INDIVIDUALS WITH AN16
INCOME OF UP TO TWO HUNDRED FIFTY PERCENT OF THE FEDERAL POVERTY17
LINE WHO PURCHASE INSURANCE ON THE EXCHANGE , AND PROVIDING18
COVERAGE FOR QUALIFIED INDIVIDUALS AT THE 2025 CALENDAR YEAR19
ENROLLMENT LEVEL;20
(B) C
OVERING THE COSTS OF ENSURING COMPLIANCE IN THE21
INDIVIDUAL MARKET WITH THE FEDERAL HYDE AMENDMENT OR A SIMILAR22
AMENDMENT; AND23
(C) S
UPPORTING ADDITIONAL AFFORDABILITY EFFORTS TO24
MAINTAIN OR INCREASE COVERAGE IN THE INDIVIDUAL MARKET .25
(III) T
HE COMMISSIONER SHALL NOTIFY CARRIERS OF THE HEALTH26
INSURANCE FEE AMOUNT FOR THE CALENDAR YEAR NOT LATER THAN27
HB25-1297
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FEE AMOUNT IS ASSESSED.2
(b) The enterprise shall use the fee, the special assessment on3
hospitals, and any other money available in the fund as follows, allocated4
in accordance with subsection (2) of this section:5
(II) To provide payments to carriers to increase the affordability6
of health insurance on the individual market for Coloradans who receive7
the premium tax credit PURCHASE INSURANCE ON THE EXCHANGE ;8
(VI) T
O COVER THE COSTS OF ENSURING COMPLIANCE IN THE9
INDIVIDUAL MARKET WITH THE FEDERAL HYDE AMENDMENT OR A SIMILAR10
AMENDMENT; AND11
(VII) T
O SUPPORT ADDITIONAL AFFORDABILITY EFFORTS TO12
MAINTAIN OR INCREASE COVERAGE IN THE INDIVIDUAL MARKET .13
(2) (d) (I) The enterprise shall allocate the revenues collected in14
2023 and each year thereafter
THROUGH 2026, and any other money15
deposited in the fund in 2023 and each year thereafter THROUGH 2026, in16
the following amounts and order of priority:17
(IV) F
OR THE 2025 AND 2026 CALENDAR YEARS, THE ENTERPRISE18
MAY USE A PORTION OF THE REVENUES COLLECTED IN 2025 AND 2026 FOR19
THE PURPOSES SPECIFIED IN SUBSECTIONS (1)(b)(VI) AND (1)(b)(VII) OF20
THIS SECTION.21
(e) T
HE ENTERPRISE SHALL ALLOCATE THE REVENUES ASSESSED22
FOR THE 2026 CALENDAR YEAR AND FOR EACH CALENDAR YEAR23
THEREAFTER, AND ANY OTHER MONEY DEPOSITED IN THE FUND IN 202624
AND EACH YEAR THEREAFTER , IN THE FOLLOWING WAY:25
(I) U
P TO FORTY PERCENT FOR SUBSIDIES FOR STATE-SUBSIDIZED26
INDIVIDUAL HEALTH COVERAGE PLANS PURCHASED BY QUALIFIED27
HB25-1297
-4- INDIVIDUALS;1
(II) U
P TO FORTY PERCENT TO THE REINSURANCE PROGRAM CASH2
FUND;3
(III) U
P TO TEN PERCENT TO REDUCE THE COSTS OF INDIVIDUAL4
HEALTH PLANS FOR INDIVIDUALS WHO PURCHASE AN INDIVIDUAL HEALTH5
BENEFIT PLAN ON THE EXCHANGE ;6
(IV) U
P TO THREE AND ONE -HALF PERCENT FOR ACTUAL7
ADMINISTRATIVE COSTS AS SET FORTH IN SUBSECTION (1)(b)(IV) OF THIS8
SECTION; AND9
(V) U
P TO SIX AND ONE-HALF PERCENT, AND ANY MONEY10
REMAINING AFTER THE ALLOCATIONS ARE MADE IN THIS SUBSECTION11
(2)(e),
THAT THE COMMISSIONER MAY DESIGNATE FOR :12
(A) A
NY ALLOCATION SPECIFIED IN THIS SUBSECTION (2)(e); OR13
(B) N
EW AND EMERGING HEALTH INSURANCE AFFORDABILITY14
INITIATIVES, INCLUDING THE PURPOSES SPECIFIED IN SUBSECTIONS15
(1)(b)(VI)
AND (1)(b)(VII) OF THIS SECTION AND HEALTH INSURANCE16
AFFORDABILITY CASH FUND RESERVES .17
SECTION 3. In Colorado Revised Statutes, 10-16-1206, amend18
(1)(f) and (1)(g); and add (1)(h) as follows:19
10-16-1206. Health insurance affordability cash fund -20
creation - repeal. (1) There is created in the state treasury the health21
insurance affordability cash fund. The fund consists of:22
(f) All interest and income derived from the deposit and23
investment of money in the fund; and
24
(g) The federal share of the medical assistance payments received25
pursuant to section 25.5-4-503 (2);
AND26
(h) G
IFTS, GRANTS, OR DONATIONS RECEIVED FROM PRIVATE OR27
HB25-1297
-5- PUBLIC SOURCES FOR THE OPERATION, RESERVES, AND SUSTAINABILITY OF1
THE ENTERPRISE.2
SECTION 4. In Colorado Revised Statutes, 10-16-1207, add3
(4)(e) as follows:4
10-16-1207. Health insurance affordability board - creation -5
membership - powers and duties - subject to open meetings and6
public records laws - commissioner rules. (4) The board is authorized7
to:8
(e) S
EEK, ACCEPT, AND EXPEND GIFTS, GRANTS, OR DONATIONS9
FROM PRIVATE OR PUBLIC SOURCES FOR THE OPERATION , RESERVES, AND10
SUSTAINABILITY OF THE ENTERPRISE. THE ENTERPRISE SHALL CONSIDER11
THE FEASIBILITY OF ALLOCATING GIFTS, GRANTS, OR DONATIONS RECEIVED12
FROM SPECIFIC LOCALITIES OR DIRECTED TO SPECIFIC LOCALITIES TO BE13
USED ONLY IN THOSE LOCALITIES.14
SECTION 5. Safety clause. The general assembly finds,15
determines, and declares that this act is necessary for the immediate16
preservation of the public peace, health, or safety or for appropriations for17
the support and maintenance of the departments of the state and state18
institutions.19
HB25-1297
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