Moving the needle with the Colorado Option | OPINION

Creating change in the huge and bureaucratic health care industry is like setting a new fitness goal — it's difficult to get started, and though people may cheer you on in theory, many skeptics, even ourselves sometimes, say, "Yeah, you're not really gonna do it. It won't stick. See ya back here on the couch in a month."

If you stay committed to that goal, you'll see the results of consistent hard work in time. In the case of the Colorado Option, we are seeing how consistent advocacy and implementation can significantly impact the individual marketplace. A policy that perhaps could only run a mile 2 years ago, is now about to compete in its second marathon, and naysayers are having a harder time disproving its success.

The "new" Colorado Option is working. It is stronger than ever, enrollments have more than doubled in the first two years, customer satisfaction is higher and the program is already an industry standard, not an outlier.

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Colorado's health insurance plan known as the Colorado Option has indeed changed how consumers interact with insurance. According to a new report by the Colorado Consumer Health Initiative tracking the plan's initial development since 2013, more and more Coloradans are choosing the plan. Consumers are happy the plans make comparison shopping easy, offer higher-quality coverage for the price, improve health outcomes for historically and structurally marginalized communities, and make services like primary, pregnancy and mental health care more accessible.

The report also finds the Colorado Option plans have been popular. Plan Year 2024 saw an increase of 188% over last year's demand, with now more than 102,000 Coloradans enrolled in Colorado Option plans, accounting for a third of all enrollments through Connect for Health Colorado. Supply has grown, too: there's a new issuer in Colorado (SelectHealth), Denver Health's Elevate Health Plan expanded and may continue to expand in 2025, and there's much-needed competition in 12 counties from existing issuers.

To those Coloradans who pay for their own insurance with tax credits, the net premium prices can be surprisingly low: more than 32,000 Coloradans pay an average of just $52 a month for silver-level coverage. We all know those first steps to change habits and ingrained practices are the hardest, but it can be done. We got off the couch, we're making the change, it's working. And, just like fitness, we have to keep it up, to see the change through.

Consumers, policymakers and those who work in health care have contributed artifacts, data and their personal stories to the report. Those contributions answer which of the policy objectives have been achieved, how the Colorado Option serves consumers, which issues remain to be fully addressed and what lessons were learned along the way. These new data show how this uniquely inclusive policy improves market participation and has created a product Coloradans want.

Our report concludes the Colorado Option is liked for other reasons, too: it has been more inclusive in its creation and implementation — instituted with extensive input from consumers, insurers, health providers, community groups representing people of color, rural communities and other stakeholders; consumers love the standardization across "metal levels" which makes comparison shopping easier than ever before; its "patient-first" emphasis makes it easier to be healthy; and that Colorado Option plans are more affordable partly because patients aren't paying extra to visit their therapist, regular doctor or for some medical supplies.

One Colorado Option enrollee quoted in the report stated, "It covered the most prescriptions… And it indicated that I would probably, with prior authorization, be able to stay on the insulins I was on," she said.

Our report uses data and audio of consumer voices and enrollment assisters to demonstrate how the $0 copays for preventive services that are not subject to deductibles, copay-only prescriptions and easy-to-understand plan design lead to better care. Notably, 88% of customers who selected a Colorado Option plan indicated $0 primary care and mental health visits are an important factor when enrolling into a Colorado Option plan. See — and hear! — the report here (note that you may have to download the report to play embedded audio clips).

The Colorado Option was passed by the legislature in 2021 to address the growing affordability crisis driven by skyrocketing health care costs. Colorado Option plans are standardized with the same benefits and cost-sharing in each "metal level" of coverage regardless of the insurance company, making it easier to make choices based on quality, providers that participate in the plan and price. The plans prioritize benefits that improve accessing basic care, address health disparities and begin creating culturally responsive provider networks. The report concludes many of those goals are being met or improved by this innovative policy.

We know there is a longer trajectory for the full impact of the Colorado Option to be realized, but we are seeing and hearing clearly how this policy is working and benefiting Coloradans right now. Consumers understand the standardized Colorado Option plan, can access more services to maintain their health without cost barriers and are voting with their feet and enrolling in these plans. That's a huge success. We're moving the needle, and now we're going to see how we can maximize affordability gains for Coloradans

Adam Fox is deputy director of the Colorado Consumer Health Initiative.