The Affordable Care Act

The Affordable Care Act, also known as Obamacare, seeks to increase the quality and affordability of health insurance, reduce the number of uninsured people and reduce the costs of health care.

The law:

  • Mandates that all citizens have health insurance or face a penalty. Read more about how we can help you avoid a fine.
  • Makes health insurance companies cover all applicants and offer the same rates – regardless of their sex or their health.
  • Requires all health plans to cover 10 Essential Health Benefits
    • Ambulatory patient services
    • Emergency services
    • Hospitalization
    • Maternity and newborn care
    • Mental health and substance use disorder services, including behavioral health treatment
    • Prescription drugs
    • Rehabilitative and habilitative services and devices
    • Laboratory services
    • Preventive and wellness services and chronic disease management
    • Pediatric services, including oral and vision care

    Any provider, including (but not limited to) Doctors of Chiropractic, can provide care for those Essential Health Benefits that are within his/her scope of practice under Colorado law.  More information about provider non-discrimination and chiropractic services is available in a bulletin issued by the Division of Insurance.

  • Requires all plans to include FREE preventive services:
    • Blood pressure screening
    • Breast cancer screening and mammography
    • Cervical cancer screening (pap test)
    • Cholesterol screening
    • Colorectal cancer screening
    • Depression screening
    • Obesity screening and counseling
    • Adult immunizations (flu shots, Hepatitis A and B, and pneumonia vaccines)

Financial Assistance for Individuals

Under the Affordable Care Act, a new tax credit called an Advance Premium Tax Credit (APTC) is available, if you qualify, that can help you afford coverage purchased through Connect for Health Colorado. Unlike tax credits that you claim when you file your taxes, these credits can be used right away to lower your monthly premium costs. If you qualify, you may choose how much to apply to your premiums each month and whether you want to leave some unclaimed until you file your taxes.

You may also be eligible for savings, called Cost Share Reductions, when you access care to help reduce things like co-pays, deductibles and coinsurance. The amount that you qualify for will depend on your family income and family size. Lower income families and individuals get the most help.  On average, Connect for Health Colorado customers received $230 per month for 2015 coverage.

You will learn exactly how much you can receive when you enroll. Individuals can get an estimate of their potential financial assistance using our Tax Credit Estimator.

Employer Tax Credits

An employer with fewer than 25 full-time equivalent employees making an average of about $50,000 a year or less (not counting the business owner or family members) can qualify for a tax credit for sponsoring employee health coverage.

To qualify for the Small Business Health Care Tax Credit, an employer must pay at least 50 percent of full-time employees’ premium costs. Employers do not need to offer coverage to part-time employees or to dependents.

The tax credit is worth up to 50 percent of your contribution toward your employees’ premiums (up to 35 percent for tax-exempt employers). Small Businesses can use our Small Business Tax Credit Calculator to get an estimate of their potential financial assistance.