Colorado sets health coverage funding shares and permits bonds

The state treasurer transfers $40 million from the marijuana tax cash fund to the health insurance affordability cash fund. The money moves between two state funds, with the receiving fund used for health insurance affordability programs. The transfer is due by June 30, 2026; this transfer provision is repealed effective July 1, 2027.

The enterprise may issue revenue bonds and pledge money in its fund or certain enterprise revenues to repay them. The authority applies to the health insurance affordability enterprise and its fund. Bond repayment terms may extend up to 45 years from issuance. The enterprise may issue bonds on or after January 1, 2027, for purposes allowed under this part, with total proceeds of up to $100 million and approval by board resolution. The enterprise must account for savings from the specified reinsurance adjustment when setting the bond amount. Bond obligations must be paid before fund money is allocated to programs; federal money cannot be pledged. The enterprise may issue bonds on or after January 1, 2027; repayment terms may extend up to 45 years from issuance.

The enterprise allocates money to individual coverage subsidies, reinsurance, lower exchange plan costs, administration, and federal amendment compliance. The rules cover revenue assessed for 2027 and later, bond proceeds, the $40 million transfer, and other money deposited for those years. For 2027 and later, the enterprise allocates at least 20% to subsidies for qualified people who pay premiums for state-subsidized individual plans, at least 50% to the reinsurance program cash fund, and at least 25% to lower costs for people buying individual plans on the exchange. Up to 3% may go to actual administrative costs; the enterprise also allocates the actual costs of complying with the federal Hyde Amendment or a similar amendment. After those allocations, remaining revenue is directed toward an 18% average premium reduction in reinsurance, premium assistance and coverage at 2026 levels, and other affordability efforts. If money remains on August 1, the enterprise may reallocate certain unspent amounts among specified purposes, but not administrative costs. These allocation rules apply to the 2027 calendar year and each year after it.

The enterprise studies possible program changes and reports to lawmakers; its board seeks input from affected people before certain recommendations. The duties apply to the health insurance affordability enterprise and board. The input process covers people directly affected by enterprise-funded programs when the board makes the specified recommendations. The study examines whether restructuring could improve affordability and enrollment, including a possible basic health program; it does not itself establish that program. Before certain final recommendations about plans, coverage, or eligible slots, the board seeks input from people directly affected by enterprise programs and offers participation in English and Spanish. To the extent practicable, it also offers other languages when requested at least seven days in advance. The enterprise reports fund information to the Joint Budget Committee and gives it an annual in-person briefing. The study is due by July 1, 2027, with results sent to legislative health committees within 30 days; the study section is repealed effective January 1, 2028. Fund reports start with the September 2026 forecast, and annual briefings begin by January 15, 2027.