Health insurance enrollment declines in Colorado, but not as much as feared

The number of people signing up for health insurance plans through the state's insurance exchange declined this year for the first time since 2020. But the drop wasn't as steep as state officials had feared following the expiration of key federal subsidies that made insurance more affordable for many.

Through the end of the open enrollment period that closed last week, 277,228 people purchased plans for 2026 via the exchange, Connect for Health Colorado. That is a 2% decline from last year's record enrollment number of 282,483.

Of those who signed up, 69% will benefit from the original Affordable Care Act federal subsidies, which remain in place. That is down from the 80% of people who signed up last year and received either the original subsidies or the enhanced subsidies that just expired.

Officials had worried that as many as 75,000 more people in Colorado would go without coverage this year due to the expiration of the subsidies — which Congress failed to extend after the subsidies became the focal point of the longest federal government shutdown in history.

"On one hand," said Kevin Patterson, the CEO of Connect for Heath, in a statement, "it's encouraging to see enrollment remain relatively steady, with only a slight dip, and to see so many people receive meaningful financial assistance."

But numbers released Thursday by Connect for Health Colorado still contained worrying signs, and ultimately it is unclear how many people dropped or opted not to purchase coverage this year.

Enrollment last year rose by about 45,000 people over the year before, and it had climbed by about 35,000 people the year before that. It is unclear whether that trend would have continued for 2026 if the additional subsidies had remained in place.

Cancellations by people who purchased plans during open enrollment and then later dropped them also spiked. The 17,000 people in that group — many of whom had plans that auto-renewed — represented an 83% increase over last year, Patterson said.

Enrollment among new customers dropped 24%, Connect for Health reported. And enrollment declines were steeper for people age 55 and older and for those in rural areas — 6% and 5%, respectively. Both of those groups were hit harder by the loss of subsidies.

"It's deeply troubling that a record number of people are canceling their plans because they simply can't afford their monthly payments, or are being forced to choose between health care and basic necessities like housing and food," Patterson said in his statement.

Consumer advocates credited state funding passed during the legislature's special session last year with preventing deeper coverage losses. But that was a one-time fix, and lawmakers this session must find a new funding source to continue the same level of support for affordability programs.

Adam Fox, the deputy director of the Colorado Consumer Health Initiative, said he is worried the state may see additional insurance cancellations as costs pile up.

"We're concerned more Coloradans will drop coverage as they struggle to afford their premiums," he said.Congress continues to debate whether to extend the expired subsidies. The U.S. House approved a three-year extension earlier this month, but the chances of an extension in the Senate are less clear.