DOI holds public meetings to discuss timeline and plans for their draft 1332 waiver amendment


Patrick Jones


The Colorado Division of Insurance (DOI) under the Department of Regulatory Agencies (DORA) recently held two public comment meetings for their draft 1332 waiver amendment. These meetings included background into the waiver, the goals of the waiver, and were open to questions from the public. 


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Kyle Brown, the deputy commissioner of DOI, highlights that the main purpose for this waiver amendment is to use federal pass-through funding from savings from the Colorado Option to assist those who are not eligible for federal subsidies. These savings will come from the reduced premium rates from the standardized plans of the Colorado Option. 

“The 1332 waiver that we are discussing tonight [will allow for] the ability to use federal savings from the premium reductions to expand access to affordable quality coverage.”

In a presentation given by Brown he explains the important statutory guardrails that limit the extent of the changes that a state can make within the waiver. 

One guardrail is continued comprehensiveness, which requires the waiver to provide coverage at least as comprehensive as coverage without the waiver. The waiver must also retain affordability by providing cost-sharing projections against excessive out-of-pocket spending at least as affordable as absent the waiver. 

Another guardrail includes providing health care coverage to a comparable number of residents as absent the waiver. It must also not increase the federal deficit. 

Brown also highlights the key dates around the application and federal response to the waiver. Below is an image from the Colorado Option page on the DOI website showcasing the key dates. 


Image: Colorado Department of Regulatory Agencies


Public comment for draft 1332 waiver amendment will end on Nov. 15 with hopes to submit the amendment for federal approval by Nov. 30. DOI expects a response from the federal government relating to the waiver by Aug. 2022.

In discussing the impact of the waiver, if rate reductions are achieved through the reinsurance program and the Colorado Option, average premiums in Colorado will reduce by 22.9% by 2023 and 34.9% by 2027. This will save the federal government $209 million in 2023 and $398.8 million in 2027, all of which will go towards insuring those who do not qualify for federal subsidies. 

Here is a summary of the waiver impact. 


Image: Colorado Department of Regulatory Agencies


Brown also says the waiver will address health inequities in the state. He says people of color are disproportionately uninsured in Colorado. The amendment focuses on insuring the uninsured to target those inequities and assist people of color. 

“By expanding coverage for folks, we believe we are disproportionately impacting coverage for folks who are people of color in a positive way.”

In the Q&A section of the meeting, an attendee asked what happens if the premium reductions are not met on time, which has been a concern for health plans throughout the state. Brown says the Colorado Option bill — HB 21-1232 — allows DOI to have the authority to make sure that the premiums get met. He says they will continue to work with the federal government to make sure the state is receiving the proper amount of savings.