Rep. Diana DeGette (D-CO) held a press conference with health care leaders in Colorado and Affordable Care Act (ACA) enrollees today to draw attention to the recent Republican-led budget bill, referred to as the “Big Beautiful Bill”, and how it will drive up health insurance premiums.
House Republicans, including the Republican members of Colorado’s congressional delegation, have claimed that the cuts made to Medicaid and other health benefits were about removing “illegal immigrants” and “able-bodied adults” from these services. However, the Congressional Budget Office, a nonpartisan entity that assesses the impact of federal legislation, has projected that the bill will increase the number of insured Americans by over 10 million by 2034 while increasing the federal budget deficit by $3.4 trillion.
The Colorado Division of Insurance recently released data that estimates an average increase of insurance premium costs by 28% by 2026 as a result of Congress’s failure to extend an ACA tax credit. In rural areas like the Western Slope, the increase is expected to be as high as 38%.
“As you can see from this chart here, there has been a recent release of data for Colorado that shows that a combination of the ‘Big Bad Bill’ that was passed by Congress last month and the failure of congressional republicans that were expecting at the end of the year to extend enhanced ACA tax credits is going to cause a 28% in premiums here in Colorado,” DeGette said. “In the Western part of the state, including Grand Junction, we’re going to see premium increases over 38% for the next year which is, to me, shocking. Take a look at this, insurance rates were actually going down until this legislation passed and now they’re shooting up. That’s not just for people who are on Medicaid, that’s the insurance rates for all of Colorado. Driving these increases is the loss of additional financial assistance that helps middle-class Coloradans afford health insurance. Congress is letting this assistance expire on December 31st and those resulting premium increases will impact 321,000 Coloradans. To put a finer point on it, average statewide increases were 5.6% in 2025, 9.7% in 2024, 10.4% in 2023, and 1.1% in 2022, and the expectation is that it will be a 28% increase next year. Nearly 10 million more Americans have gained coverage since 2021 thanks to enhanced premium tax credits, and if these expire as expected in 2025, over 5 million people will lose their health insurance.”
DeGette, who is the ranking member of the United States House Energy Subcommittee on Health, warned that the expiration of the enhanced premium tax credit, coupled with cuts to Medicaid in the Big Beautiful Bill, will have devastating financial and health repercussions for Coloradans.
“We have had the lowest uninsured rate that we have had for many years in the United States because of these tax credits and because people are finally able to afford insurance. If you add this loss to the Medicaid cuts that are expected to take place starting in 2028, this is going to raise costs not just for Medicaid recipients, but for everybody with private insurance,” DeGette explained. “The Congressional Budget Office estimates that 15 million people will lose health coverage by 2034, due to the 10 million losing coverage from Medicaid and ACA marketplace cuts, 4.2 million who will lose coverage through a premium tax credit since it expires, and 900,000 more will lose coverage due to other marketplace rule changes based on earlier estimates. All of these cuts and all of these increases in insurance costs are being done for one reason, to offset the high tax benefits being given mostly to the very richest– the billionaires and millionaires in this country. In the meantime, working families, low-income adults and people who are here in this country lawfully, immigrants, are going to see their insurance rates rise. Even if people get a small tax from this ‘Big Bad Bill’, that’s going to be wiped out because most adults who will lose Medicaid coverage are going to have to pay $2,200 more per year in annual out-of-pocket costs. My friends across the aisle keep saying, ‘Oh no, we’re not taking millions of Americans off of healthcare’, but in fact, the non-partisan congressional budget office said that 16 million Americans are going to lose their healthcare, either because of the Medicaid cuts or because of the expiration of this tax credit. These are not people who are able-bodied workers who are just sitting at home as the Republican Party claims. These are Americans who can’t navigate the red tape, they’re people who are getting the tax credits right now who are going to lose them, most of them are people who are already eligible. The bottom line is that this is going to impact every Coloradan and, if this bill continues, it’s not just going to impact them next year, it’s going to impact them for the foreseeable future as these devastating effects take effect more and more.”
DeGette was joined by experts in Colorado healthcare like Casey Guber, the CEO of HCA HealthONE Rose, the hospital where the press event was held.
“Our colleagues and providers here at HCA HealthONE Rose work every day to ensure our patients and the communities we serve receive exceptional care; these are our friends, our family members, and our neighbors,” Guber said. “Providing healthcare in this environment is already extremely challenging, which is why it’s critical that Congress steps in to ensure enhanced premium tax credits remain in place. Enhanced premium tax credits were put in place in 2021 to help working families in Colorado and across the country access health insurance as the cost of this care increases. The program has been a tremendous success in helping keep Americans and Coloradans covered. The premium tax credits expire at the end of this year, and this is deeply concerning; if these tax credits expire, hundreds of thousands will see their premiums dramatically increase. Additionally, many may lose coverage because they can’t afford it.”
To provide an example of the impact of the change in federal healthcare policy, Guber laid out several scenarios.
“I’d like to end with a few scenarios, if the enhanced premium tax credits sunset, these numbers will show how crippling this will be to Americans in Colorado that utilize the program,” Guber said. “If a 60-year-old couple earning about $80,000 a year loses their credits, their premiums will go up by almost $16,000 a year. A family of four earning $130,000 a year will see their premiums increase by $7,800 a year. In this last scenario, a family of 4 earning $64,000 a year would see their premiums increase by $2600 a year. That’s real money that could be using it for food, transportation or other basic needs. All these would have devastating impacts on our community and I ask that people step in to ensure that they remain in place.”
Hospitals, especially rural hospitals, are expected to face additional hardship as more care is pushed towards their emergency departments. The vice president of the Colorado Hospital Association, Megan Axelrod, warned that failure to extend the enhanced premium tax credits would be devastating for Colorado families and healthcare workers.
“It’s critical that Congress acts to extend the enhanced premium tax credits before the end of this year, otherwise there will be devastating impacts to Colorado families,” Axelrod said. “To the extent that many individuals will likely go uninsured, that is not care that goes away. That is care that becomes more expensive and ultimately is funneled through the emergency department because you are not getting care at the right time, at the right place, at the most cost-effective intervention. What that means for Colorado hospitals as costs continue to rise across the system, since 2019, you’ve seen really dramatic increases in the amount of charity care that hospitals are providing, especially through their emergency departments. At this time, 70% of Colorado hospitals across the state are operating without sustainable margins. To the extent that they are serving their obligations to provide individuals with care across the emergency departments and other community hubs, we are seeing that in the numbers already.”
Axelrod said that as costs to hospitals increase, many will have to divert resources for other departments to sustain the increased reliance on emergency services.
“As hospital costs continue to increase, we expect there will be significant coverage losses through other provisions that have come through at the federal level. We anticipate that hospitals will spend more on the care provided in the emergency department, those costs will rise and as the sustainability factors are really at play and hospitals are at risk, you will see services start to shift in the communities and really funnel to our emergency departments. We are at a critical point to really extend these tax credits and ensure access to care to those who need it.”
Adam Fox, the Deputy Director of the Colorado Consumer Health Initiative, a non-partisan healthcare advocacy group, argued that the reconciliation bill would drive up costs for low and middle-income families across the state, with pronounced impacts in rural communities.
“The vast majority of these [cost] increases are attributable to the decisions that Republicans have made in their ‘Big Beautiful Bill’ and ultimately it’s going to have ugly consequences for Colorado,” Fox said. “What we know is that HR1 and the expiration of these enhanced premium tax credits throw the health insurance market into chaos. It deals a major blow to the stability of the insurance risk pool and that is what is driving these base rate increases. The combination of those rate increases with the termination of the enhanced premium tax credits is going to have a magnifying effect, and it’s going to be devastating for Coloradans. An estimated 34,000 Coloradans will lose financial assistance altogether, and it is highly unlikely that they will be able to continue to afford health insurance. This is particularly true in rural parts of the state where health insurance premiums are already higher than they are here in the Front Range. The failure to extend the enhanced premium tax credits in HR1 and the other changes being made to the Affordable Care Act are unconscionable. Republicans may not have gone for fully repealing the ACA, but they are doing everything they can to strangle it, and they are driving up costs for millions of Americans.”
Laura-Elena Porras, the Health Policy and Coverage Program Director for Doctors Care, a Littleton-based clinic that primarily serves ACA recipients, was concerned that changes would force low-income Americans to go without the care they need.
“Doctors Care is a safety net clinic and community health center in Colorado; however, we’re more than just a clinic, we’re a health access hub,” Porras said. “We provide care and connect people to coverage so they can stay healthy and avoid long-term impacts. Our bilingual health coverage guides work year-round to assist families on the Connect for Health Colorado marketplace, as well as Medicaid. Most of the people we serve are working hard to make ends meet, earning under $35,000 a year for a single person or $65,000 for a family of three. The enhanced ACA subsidies have made coverage possible for these families, and were a part of that story, but without them, many would be uninsured. With the expiration of these subsidies and no extensions in HR1, we’re bracing for major disruptions in our programs. We expect higher premiums, more confusion, and fewer people getting covered. Affordable coverage means managing chronic conditions, going to preventative visits, and accessing specialty care like mental health services or complex procedures. When coverage becomes unaffordable, specialty is often the first to go.”
Finally, Chelsea Baker-Hauck shared her experience of receiving life-saving care through the tax credits. Baker-Hauck developed an autoimmune disorder after she contracted COVID-19 early in the pandemic; ultimately her experience with the virus left her disabled and changed the trajectory of the Denver resident’s life.
“I’m one of the faces behind the statistics, and I’m here to tell you how the proposed insurance rate changes and expiration of the enhanced premium tax credits will impact me and people like me. I’m 52, I have a master’s degree, until recently my only debt was a mortgage,” Baker-Hauck said. “I did all the things right, I operated a successful, small consulting business and relied on the Colorado’s marketplace for insurance. In early 2020, I caught COVID-19, and I never got well. The infection damaged my heart, and I developed an autoimmune disorder that attacks my nervous system, I’m now permanently disabled. For more than a year, I fought to get my insurance carrier to cover the treatment that would save my life. In 2023, I was finally able to start that treatment, now every two weeks, I spend two full days in an infusion center receiving IV-immunoglobulins through a port in my chest. With this treatment, I’m able to work part-time, swallow, digest solid food, walk, talk, use my hands, drive, live without severe pain, and even return to some of the activities I loved before I got sick. But if I miss even a single dose, I start to lose it all again.”
Baker-Hauck said that she, and millions of Americans like her rely on insurance to cover the cost of life-saving treatments.
“Here is the thing: I rely on insurance. This treatment is really expensive; it is $8600 a dose, that’s $17,200 every two weeks, more than $34,000 per month, and $412,000 per year,” Baker-Hauck continued. “This treatment is saving my life and it makes it possible for me to live life. This health insurance coverage is imperative; my life and my ability to continue working and contributing to my community depends on access to insurance. It is hard to know for certain how much I’ll be affected by the proposed rate changes coupled with the expiring enhanced premium tax credits, my best estimate … is that our deductible and the medical expenses our insurance doesn’t cover will consume more than 42% of my income next year. I already can’t afford that healthcare, we’ve emptied our savings, my husband’s retirement fund, and we’ve acquired $10,000 in medical debt last year. My husband also went without cancer care last year because we couldn’t afford to pay his deductable too. I ration the medications I pay out of pocket for and in some cases, I take expired medication because I can’t afford a new prescription. Millions of other Americans make these same types of choices every day, do I eat or do I buy medicine, what do I cut when there is nothing left to cut? If I cut insurance, I will die, it’s that simple. How can any middle-class American be expected to carry this financial burden, they can’t, its unworkable. It’s going to be worse. At a time when millions of Americans like me are facing medical complications of long COVID, we should be making healthcare more affordable and accessible, not less. Republicans in Congress have taken an imperfect healthcare system and broke it entirely, the rich will get their tax cuts and insurance companies will still report record profits. But ultimately, its everyday people like me who are going to pay, and in some cases we can pay with our lives.”
Congresswoman DeGette was asked what her message was to her colleagues as the conference concluded.
“We’re dealing with people’s lives here,” DeGette said. “This is not some abstract offset to their tax cuts. This is money that people, Chelsea and her husband, are having to pay to get the healthcare they need. So when Congress comes back in September, we need to extend the tax relief that was already in place, and we also need to repeal this big, bad bill. I don’t know if the Republicans intend to do this right away, but I know they’re hearing from their constituents over this recess. This is not abstract; these are real lives and millions who could lose access to care.”
