With Medicaid redeterminations around the corner, over 40,000 individuals signed up for Colorado Option plans during 2023 open enrollment
Total Colorado Option enrollments reached 39,871 as of Jan. 31st, according to the Department of Regulatory Affairs on Wednesday.
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Of all these enrollees, 142 enrollments were by small group plans that have two or more enrollees, which suggests actual enrollment exceeded 40,000.
Colorado Option enrollment comprises 13.7% of the more than 200,000 consumers on the state’s health exchange, Connect for Health Colorado. Over 80% of Colorado Option enrollees on the exchange received financial assistance in the form of either Advance Premium Tax Credits (63.5%) or cost-sharing reductions (24.6%), which contributed to average net premiums of $202, $72, and $296 for Bronze, Silver, and Gold metal tier plans, respectively.
There were also more than 10,000 off-exchange enrollments through Colorado Connect, where people who are undocumented can go to sign up for healthcare coverage.
The enrollment update was provided during Wednesday’s Colorado Option Advisory Board meeting, where some of the state’s on-the-ground efforts around the PHE unwinding were touched upon.
“There’s so much effort on the ground amongst those different levels of organizations to do direct outreach to people on Medicaid as the public health emergency unwinds,” said Jen Fanning, executive director of Grand County Rural Health Network and advisory board member. “In fact, my navigation team is on a call at the moment … talking exactly about that level of information and how to work with health coverage guides and how to get information out there. So I do know there’s just been a tremendous amount of information out there.
Is it talking about Colorado Option specifically? I don’t know that for sure. It’s talking about directing people to Connect for Help and certified health coverage guides and getting them on that pathway. So I think [people losing Medicaid] will see that [the Colorado Option] is one of the best options.”
The Division of Insurance (DOI) shared its 2022 milestones around the Colorado Option program, which included the establishment of the advisory board, completion of plan and rate filing, and federal approval of the 1332 waiver amendment. The federal approval allows the state the financial flexibility to implement the premium rate reductions required by the initiative and was essential to initiating the open enrollment.
DOI reported the federal government is currently reviewing its administrative templates submitted last fall related to Colorado Option and the state’s reinsurance programs to determine the amount of pass-through dollars both programs will receive.
The funding will be critical in the current inflationary environment, which raised concerns among hospital providers during the meeting about the expense structure of the program.
“I don’t want to take up a lot of time in the committee, but we have to have that discussion of the reality of healthcare economics right now,” said Kevin Stansbury, CEO of Lincoln Community Hospital and Care Center and advisory board member. “I understand that hospitals are sort of the center point of a lot of those costs coming together. But my little hospital in Hugo, Colorado [has] very little ability to negotiate with [medical suppliers], or even temporary staffing agencies to bring down my costs. They just won’t do it.
Yet the federal government comes in and says, ‘Oh by the way, we’re reducing your Medicare reimbursement by 2%.’ And Medicaid gives us a 2% raise—thank you for that—but it’s not keeping up with my approximate 20% inflation this year.”