Financial Relief Defray Individual Health Plan Cost

The bill creates a financial relief program, available from July 1, 2017, through December 31, 2018, or until the total amount of money appropriated for the program is distributed, to provide financial assistance to individuals and their families residing in the program area who spend more than 15% of their household income on individual health insurance premiums. The Colorado health benefit exchange (exchange) is to oversee the program, and counties in the program area may elect to administer the program in their counties. For any county that opts not to administer the program, the exchange is to administer the program in that county.

Financial relief is available to individuals and families residing in the program area who are determined eligible based on the following:

• The individual or family enrolled in and paid premiums for a bronze, silver, or gold level individual health benefit plan purchased through the exchange;
• The individual or family has a household income of more than 400%, but not more than 500%, of the federal poverty line;
• The individual or family does not have access to a government-sponsored program, such as medicaid or medicare, or an affordable employer-sponsored plan; and
• The individual or family pays more than 15% of the household income on premiums for the plan.

The exchange is to certify that an individual or family resides in the program area and has enrolled in one of the specified health benefit plans, the premium amount of the plan, the household income of the individual or family, and that the individual or family does not have access to a government-sponsored program or employer-sponsored plan.

The amount of financial relief is calculated based on the cost of the premium for the lowest-cost bronze health benefit plan available to the individual or family through the exchange, minus an amount equal to 15% of the individual's or family's household income. The general assembly is to appropriate not more than $5.7 million from the general fund to the department of health care policy and financing, for allocation to the exchange to provide financial assistance to individuals who qualify under the program.

A carrier offering individual health benefit plans on the exchange must permit an individual to purchase an individual health benefit plan on the exchange during a special enrollment period that begins June 1, 2017, and ends August 1, 2017, for plans effective through December 31, 2017. For the 2018 plan year, individuals are subject to the standard open enrollment period specified in law.

The program repeals on September 1, 2019, unless congress enacts and the president signs legislation repealing the advance premium tax credit authorized under federal law, in which case the program repeals upon the date of the repeal of said tax credit.

The bill appropriates $5.7 million to the department of health care policy and financing for allocation to the exchange to provide financial relief to qualified individuals.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)