- A Senate stalemate means enhanced ACA premium tax credits expire Dec. 31, 2025.
- Colorado’s individual-market premiums are projected to jump about 101% on average in 2026, hitting roughly 225,000 subsidy users.
- Rural and Western Slope areas face the steepest increases, worsened by reduced state reinsurance support.
- About 75,000 Coloradans could lose coverage, straining hospitals with more uncompensated care.
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The latest legislative stalemate over ACA premium tax credits has precipitated sharp cost shifts in health insurance markets, particularly in Colorado. The Senate’s December 11, 2025 vote blocked both the Democratic proposal to maintain enhanced premium tax credits (PTCs) and a Republican alternative centered on health savings accounts; neither reached the 60 votes required. Thus, the enhanced federal subsidies will expire on December 31, 2025.
Colorado’s insurance market stands to be hit especially hard. With the expiration of enhanced PTCs, average monthly premiums for individuals shopping through Connect for Health Colorado are estimated to nearly double in 2026 — a 101% increase state-wide. The impact is most severe in rural and mountain regions: average rate requests in Western Slope counties could rise by as much as 38%, partly due to loss of subsidy support and reductions in reinsurance funding.
Beyond cost hikes, the expiration threatens coverage for many. Approximately 225,000 Coloradans rely on enhanced subsidies; now about 75,000 are projected to lose coverage. Those who maintain coverage may face premiums totaling tens of thousands more annually, especially families living outside the Front Range, where standard silver plans could increase by $16,000–$21,000 per year.
The effects stretch wider: increased uncompensated care burdens hospitals, especially rural ones facing financial vulnerability. With many uninsured likely to delay care until emergencies, both public health outcomes and healthcare infrastructure are at risk. At the state level, legislators are exploring stopgap funding via Colorado’s Health Insurance Affordability Enterprise, state reinsurance and other reforms to soften the blow.
Politically, the failure to act has deepened partisan divides. Colorado’s Democratic senators and other elected officials have condemned the shutdown deal that omitted subsidy extensions. Their opposition centers on concerns that promises of future votes are insufficient to prevent the impending premium cliff. The timing mismatch—expiration of subsidies January 1 vs. earliest possible votes—means that premiums may be set well before Congress acts.
Open questions include whether Congress can resurrect subsidy extensions early in 2026; whether state-level interventions will be sufficient to protect the most vulnerable; and the longer-term implications for markets if insurers face suddenly reduced enrollment and higher uncompensated costs.
Supporting Notes
- On Dec. 11, 2025, the U.S. Senate voted down a Democratic bill to extend enhanced ACA premium tax credits and also rejected a GOP alternative bill, setting the credits to expire Dec. 31, 2025.
- Colorado regulators predict a net average premium increase of 101% for consumers in the individual marketplace in 2026 due largely to subsidy expiration.
- About 225,000 Coloradans depend on enhanced premium tax credits; approximately 75,000 could lose coverage when credits expire.
- On the Western Slope/rural counties, annual premiums for a standard silver plan could increase by $16,000–$21,000, compared to the Front Range.
- Colorado’s reinsurance program is losing matching federal support, reducing its impact by roughly 40%, contributing about 8 percentage points to premium hikes.
- Hospitals statewide provided $335.8 million in charity care in 2023 — more than double that in 2019 — and are warning of greater strain with rising uninsurance.
- Colorado’s Democratic U.S. Senators, Michael Bennet and John Hickenlooper, opposed a federal funding deal that lacked subsidy extension; the deal promised a vote by mid-December on subsidy legislation.