If there’s one business in America where you’re expected to buy something without knowing the price, it’s health care. Too many of us have opened bills for a “routine” lab test –$500 for something that costs $50 elsewhere – or received a surprise charge in the thousands for an unexpected ER visit. Meanwhile, the United States spends almost twice as much on health care as other developed nations yet ranks near the bottom in life expectancy and preventable disease. We pay more and get less.
The Affordable Care Act helped correct longstanding inequities. It banned discrimination against people with preexisting conditions; required coverage for essential benefits such as hospitalization, mental health care, maternity care, prescriptions, and preventive screenings; eliminated lifetime caps; allowed young adults to stay on their parents’ plans until age 26; and required insurers to justify premium spending and provide appeal rights when claims are denied. These reforms strengthened consumer protections, even though affordability remains a challenge.
Many Americans are frustrated with how their tax dollars are – or are not – used to support health care. We pay taxes for schools, roads, and emergency services, and some argue that reinvesting those dollars into reliable, accessible health care throughout one’s lifetime – not just starting at age 65 – would seem intuitive. Instead, the role of government in health care has become intensely partisan, both before and since the ACA’s passage. The contrast between the stable coverage afforded to members of Congress and the challenges many constituents face continues to raise questions about fairness and long-term direction.
At the same time, Colorado families are facing a one-two punch of economic strain, with rising health care costs arriving just as many households are also navigating reductions in federal food assistance programs. When essential supports like health coverage and nutrition benefits become less stable or more expensive, the combined impact deepens financial hardship and places greater pressure on local communities.
Federal decisions directly influence what families pay. The Trump administration expanded options, such as Individual Coverage Health Reimbursement Arrangements, which allow small businesses to reimburse employees tax-free for individual insurance, and implemented price-transparency rules. But it also reduced ACA outreach, eliminated the individual mandate penalty, and supported lawsuits that contributed to market instability. Now, Colorado premiums are projected to double in 2026 unless Congress extends enhanced ACA tax credits.
The stakes are high. Colorado’s ACA enrollment has surged – from 125,402 in 2014 to nearly 296,500 enrollees in 2025, a 19% increase over the prior year. About 80% of marketplace customers receive financial assistance, with an average subsidized premium of roughly $138 per month. Still, without congressional action, an estimated 75,000 Coloradans could lose coverage in 2026 as premiums rise and affordability erodes. Statewide uninsured rates, which had fallen to 4.6% in 2023 (about 265,000 people), have already begun to rise – particularly among children and working-age adults.
Montezuma County will feel these effects sharply. In 2025, 1,126 residents – about 4.5% of the population – enrolled in marketplace plans; financially assisted enrollees pay about $139/month, while those without subsidies pay roughly $581. Meanwhile, about 9,300 Montezuma County residents – 37.29% of the population – rely on Health First Colorado (Medicaid), meaning even small affordability shifts can destabilize coverage for thousands of households.
Seniors face additional disruption. UnitedHealthcare is dropping many Medicare Advantage plans in southwest Colorado on Dec. 31, 2025. Cigna’s Medicare Advantage plan has rebranded as HealthSpring, and enrollees must re-enroll by December 7.
Help is available. On Friday, Nov. 21, 10:30 a.m. – noon, certified Medicare counselor Linda Looman will present at the Montezuma County Annex, 107 N. Chestnut Street, Cortez. Medicare Open Enrollment runs through December 7.
For private health care coverage, Open Enrollment for Connect for Health Colorado runs through January 15. To start coverage on Jan. 1, residents must enroll by December 15. Residents can work with certified local brokers – Jay Short Insurance, Hometown Insurance, Transparent Insurance Solutions, Mountain West Insurance, and the Leavitt Group – or compare plans at ConnectForHealthCO.com. Montezuma County is also served by Peak Health Alliance, which negotiates Elevate Health Plans with strong local networks and $0 primary care under Colorado Option plans.
Until federal leaders stabilize costs, local knowledge remains essential – because without our health, we have nothing.
