CMS approves Colorado's 1332 Waiver for Reinsurance Program

Coloradans will save money on health care thanks to Federal approval of State's reinsurance program.

DENVER (July 31, 2019) – Today, the Centers for Medicare and Medicaid Services (CMS) notified the Colorado Division of Insurance (DOI) that Colorado's application for a 1332 waiver to establish a reinsurance program was approved. The DOI, part of the Department of Regulatory Agencies (DORA), submitted the application on May 20. 

“For the first time in history, Coloradans in the individual health insurance market will save an average of 18.2 percent next year. Finally, we’re driving insurance premiums down,” said Governor Jared Polis.

“We are thrilled to announce that Colorado has received federal approval for our reinsurance program, which will directly reduce health care premiums for hundreds of thousands of Colorado families. Bringing down the outrageous cost of health care in our state has been a top priority for my administration from the beginning, and this is a significant milestone on our way toward achieving that goal. We’re already seeing the direct impact this program will have on premiums on the individual market. That’s thousands of dollars in savings that Coloradans can put toward paying the mortgage, saving for college or retirement, taking a family vacation, or just living their lives.”

"This is the culmination of three years of effort," said Insurance Commissioner Michael Conway. "The DOI has conducted studies, talked to CMS on a nearly constant basis, and worked with actuaries to study this from different angles. The bill came close to passing in 2018, but this year it happened. We always knew that a reinsurance program would deliver serious savings for Coloradans.

“This approval highlights Colorado as a leader in making the individual health insurance market affordable and accessible for its citizens,” added Commissioner Conway. “I am proud of all of the work over the last three years that the DOI has put into making this possible, as well as the support of Governor Polis and the Legislature. Bold actions require bold leadership.”

Reviewing the Plans and Premiums

During the rest of the summer, the DOI will continue to review the plans and premiums for 2020 for the individual health insurance market (for people who don't get their insurance from an employer or a government program) that were submitted by the insurance companies. The final, approved plans and premiums will be made available in late September or early October. 

All of the preliminary 2020 facts and figures are available on the Division's webpage for Health Insurance Plan Filings.

What is Reinsurance?

Reinsurance is a program for the individual health insurance market, the seven to eight percent of Coloradans who do not get their health insurance from their employer or a government program. It works by paying a portion of high-cost claims - such as those incurred after major accidents or due to serious health conditions. As insurance companies don’t have to pay that portion of the high-dollar claims, they can lower the premiums for individual health insurance plans.

As the reinsurance program brings health insurance premiums down, the amount of money the federal government has to spend on ACA tax credits will also go down. But rather than letting the federal government pocket the money, Colorado is asking the federal government to pass that money through to the state to fund the reinsurance program and maintain the lower premiums and stability it will bring to the individual health insurance market. The bill that established the program,  HB19-1168, directs the DOI to study the effects of the program after two years, in particular focusing on affordability and the impact to consumers eligible for ACA tax credits. For more information, visit the DOI’s “Reinsurance Program” webpage.

 

Reinsurance Approval Timeline 

2017 

  • SB17-300 High Risk Health Care Coverage Program, passed in Legislature - Directed the Commissioner to study issues related to implementing the program. 
  • Division of Insurance held a series of stakeholder meetings regarding SB17-200.
  • Issued report on high-risk health care coverage program. 

2018

2019

  • January 10th- as part of his top priorities to save Coloradans money on health care, the Governor called on the legislature to work together to pass reinsurance during his state of the state address.
  • Over a period of five months, the Governor and Commissioner engaged in many meetings with a diverse group of stakeholders and legislators, particularly important was agreement on an appropriate funding mechanism for the reinsurance program.
  • February 1st- HB19-1168 State Innovation Waiver Reinsurance Program was introduced in the Colorado House Health and Insurance Committee. 
  • February 23rd- the governor met with Secretary Azar and  Administrator Verma in Washington D.C to advocate for the approval of the waiver. 
  • March 8th- The Governor had a call with Administrator Verma to advocate for the 1332 waiver.
  • April 19th- Governor Polis and HCPF Executive Director Kim Bimestefer have a follow up call with Administrator Verma.
  • April 23rd- Governor Polis and Commissioner Conway have a call with Administrator Werma. 
  • The Governor had multiple conversations with the Colorado federal delegation to garner their  support for the 1332 waiver.
  • In order to ensure the waiver was approved in time for the 2020 plan year, the Division of Insurance took a number of actions as the bill worked its way through the Legislature including:
    • April 16 - May 16 - Public comment period regarding the draft application for 1332 waiver
    • April 22 - Public comment hearings in Loveland on draft application for 1332 waiver
    • April 29 - Public comment hearings in Denver on draft application for 1332 waiver
    • May 6 - Tribal consultation in Ignacio on draft application for 1332 waiver; met with Southern Ute and Ute Mountain Ute tribes.
    • May 7-9th- Commissioner Conway met in Washington D.C with the Colorado federal delegation to request their support for the 1332 waiver 
  • HB19-1168 State Innovation Waiver Reinsurance Program passed the Colorado Legislature.
  • May 17 - The bill was signed into law by Governor Polis in Summit County.
  • May 20- Submitted 1332 waiver application (including a full actuarial analysis) to the Centers for Medicare and Medicaid Services (CMS) 
  • May 23 - Entire Colorado Congressional Delegation submits bipartisan letter of support for the waiver application. 
  • June 5 - Received confirmation letter from CMS that 1332 application was complete.
  • June 5 - July 5 - Federal public comment period on Colorado’s 1332 waiver application
  • July 31 - Receive approval of waiver application from CMS. 

###

The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) regulates the insurance industry and assists consumers and other stakeholders with insurance issues.  Visit dora.colorado.gov/insurance for more information or call 303-894-7499 / toll free 800-930-3745

DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 1-800-886-7675


Media Contact:
Vincent Plymell
Division of Insurance
vincent.plymell@state.co.us 
p: 303-894-2261 | c: 303-910-9614