Nicolais: Spikes in health insurance marketplace could cost Coloradans more than money

Sometime next year, my wife and I will look for a new health insurance plan. She is retiring early, and we won't have access to the plans offered by her employer. Thanks to President Donald Trump and Republicans in Congress, our replacement likely will not be from the Colorado individual health insurance marketplace.

Insurers participating in the state program through which 300,000 Coloradans purchase insurance have asked for a 28% bump in prices. In an economy already dealing with growing inflation due to Trump's tariff policy, that sticker shock could be entirely unaffordable. You can bet that will be at the center of heated congressional races next year.

Trump's spending bill, supported by every Colorado Republican in Congress, garnered a lot of attention for gutting safety net programs. Estimates as high as 11.8 million adults will lose their Medicaid coverage under the provisions of that bill. It will not happen all at once and Republicans were cynical enough to ensure early losses will not be felt until after the 2026 election. But the consequences are real and are dire.

A report in the Journal of the American Medical Association, the most respected health care industry publication, found that Americans will suffer 100,000 more hospitalizations and 1,000 more deaths each year due to the bill's passage. Both will be caused by people choosing to delay health care.

The most common cause of delayed health care? No insurance.

People who already struggle to afford rent and groceries and day care have to gamble on the cuts they chose to make. When health insurance costs skyrocket and Medicaid is no longer an option, many families resort to crossing their fingers and hoping for the best.

In Colorado, that means 100,000 people who previously found individual marketplace plans will drop coverage. Instead they will hope for good health and no accidents. The most unlucky will be saddled with massive personal debt and bankruptcy pleadings. I wrote about that pattern only a couple months ago.

Worse? Because most who choose to go without insurance are healthier than average, making the gamble more favorable for them, Colorado insurers will be stuck paying bills for the frequently ill. That is a recipe for future price hikes in a downward spiral. A year from now they may be asking for a similar increase to combat the problem. It becomes a chicken and egg problem that ends with everything smashed and scrambled.

This is not a problem unique to Colorado. After I posted the Colorado Sun article reporting the requested price spike, a colleague in Michigan responded with an article reporting about similar increases in that state. In fact, the subsidies stripped under the Republican bill will affect every state to one degree or another. On Friday the health policy think tank KFF said annual premium costs would increase an average of 15% across the country with some people seeing a 75% increase.

Add that to the likelihood that all health care costs will rise as prescription drugs have been hit particularly hard by Trump's tariffs and the health insurance seems destined to become the new homeownership: simply unobtainable for a wide swath of Americans.

That will be exacerbated in rural America, where hospitals will be permanently shuttered by the Republican bill. While they paid lip service to helping protect such hospitals, the reality is those hospitals cannot survive under the conditions they created. People in those communities, some of the staunchest supporters of Trump and his congressional allies, will pay the price.

Which leads to the question: what next?

Every Democrat running for elected office should seize on this opportunity. Health care ranks high among the kitchen table issues voters care about. Furthermore, as the surprise primary victory of Zohran Mamdani in the New York mayoral race confirmed, affordability are issues one, two and three in elections right now. Watch his interviews and notice how every question comes back to affordability.

That resonates beyond partisan posturing.

It should also be a terrifying moment for Republicans like Rep. Gabe Evans and Rep. Jeff Hurd. Both districts have significant Medicaid and rural populations. Both will see larger than usual price increases to insurance rates this year. Both will have people clamoring for answers.

So far, we have not heard good answers. Evans has simply refused to accept the premise and reality of the question. Instead, he answers questions he wanted to be asked, whether they were or were not. He claims that there won't be Medicaid cuts, despite every neutral analysis pegging it in the millions. That seems like a losing strategy in one of the country's closest congressional races.

Hurd has not been much better. Despite my personal affinity for him, on the campaign trail he promised his constituents that he would not cut Medicaid. He did not keep that promise. Given that he has more Medicaid recipients in his district than any other in Colorado, that will cost him votes. If the price of alternative insurance keeps rising, that will cost him more. If 2026 turns into a wave year, the buffer he had could all but disappear.

My family is lucky. We have insurance and will be able to afford insurance in the future, whether through the individual marketplace or PERACare or some alternative. Not everyone is so lucky. Too many Coloradans will be faced with impossible choices in the near future. That is something they will carry into the ballot box.

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Mario Nicolais is an attorney and columnist who writes on law enforcement, the legal system, health care and public policy. Follow him on Bluesky: @MarioNicolais.bsky.social.

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