CHI: A repeal of the ACA would be “devastating” for Coloradans

Colorado has a lot to lose if the Supreme Court decides to repeal the Affordable Care Act (ACA), according to a report from the Colorado Health Institute (CHI) published on Thursday. The report uses state health care data to show the magnitude at which an ACA repeal would affect the Coloradans who currently depend on it. According to the report, Colorado’s general uninsured population under 65 would double — from 484,000 to 966,000 people — if the ACA were repealed.


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To show what’s at stake, the report divides the ACA’s provisions into three categories: coverage, affordability, and consumer protections. It describes how a removal of the ACA would affect dependent Coloradans in all of these areas.


Many Coloradans rely on the public marketplace for their health plans, with 181,000 Coloradans having bought insurance from Connect for Health Colorado in 2020, according to the report. If the subsidized public marketplace option is removed, these people will have to buy more expensive plans from private insurers or brokers. 

One out of three Coloradans received coverage from the state’s Medicaid expansion program in 2020, the report says. It adds that the state would lose approximately $3 billion in funding if it loses this federal support, which it would not be able to replace easily.


The report says the state could potentially lose around $700 million in federal tax credits to help people afford health care services if the ACA is repealed. Using 2020 data, the report explains that Coloradans receiving tax credit subsidies would need to pay an average of $369 more a month in premiums. Those eligible for cost-sharing reductions would also need to pay higher out-of-pocket costs. 

If cap prohibitions on medical service coverage are removed, patients might need to pay all of their expenses out of pocket if they surpassed a certain threshold. This would be harmful for people who require serious care, like cancer patients. To show the ACA’s influence in this area, the report explained that 104,000 people filed for medical bankruptcy in 2013 (prior to ACA implementation) while 36,000 did so in 2019.


Coloradans receiving contraception coverage from their health plans would also have a higher financial burden if the ACA is repealed, the report says. Even though Colorado state law requires health plans to cover contraceptives, it does not specify that they need to provide copayments or coinsurance as well.

The report explains that Colorado state law protects several ACA provisions in the absence of federal protections. Under Colorado law, young adults can still remain on their parents’ plan until they are 26. State law also upholds the required coverage of the 10 essential health benefits. Coloradans with pre-existing conditions are still given protections, and plans are still prohibited from charging older adults more than three times what they charge young adults.