In 2021, the Colorado General Assembly created the Colorado Option as a lever to support small businesses and Coloradans alike. The program, which has been supported and backed by the small business community, is a public-policy solution to rein in the rising costs of healthcare.

It’s not working out that way. Insurance carriers, brokers and hospitals are failing to engage in the small group market premium reduction process, which is integral to the success of the Colorado Option and ensuring healthcare is more affordable for all. Now the Colorado Division of Insurance has an opportunity to address this problem and ensure robust participation in the program moving forward.

Healthcare costs have always been one of the biggest barriers to small business success. A recent Small Business Majority survey found that nearly 7 in 10 small business owners say healthcare costs are a top concern for their business. It’s not surprising, then, to learn that 71% of them believe policymakers should prioritize bringing down the cost of healthcare.  

Although the Option is, on paper, getting us closer to achieving that goal, we need lawmakers and decision makers to enforce the rules and regulations of the program with close oversight to make this a reality and ensure successful enrollment in the program. Currently, insurance carriers, brokers and hospitals are not making good faith efforts to adhere to and lower healthcare costs. It’s a lamentable fact that is discouraging Coloradans, small business owners and their employees from participating in the first place.

There are three key issues preventing success in the Option’s small business program that the Colorado Division of Insurance must address.

First, insurance carriers must demonstrate that they’re on track to meet the Option’s standards and be fully transparent about how they will meet the Option’s requirements. We’ve seen that Denver Health, and at least in part Cigna, have been able to meet the premium reductions in the individual market; there’s no reason to think insurers can’t achieve the same success in the small-business market.

Many of the arguments carriers have made about why they are missing the targets are inadequately justified and set a precedent that greatly threatens the success of the Option. This program was enacted with the goal of making healthcare more affordable and accessible for Coloradans. How can we get there when those with the authority to set and negotiate the prices of healthcare services are failing to participate in the rate review process in the first place? 

Second, we are concerned that insurance brokers are not providing enough information about the Colorado Option to current and potential clients. Business owners are having a tough time finding information about the new, lower-cost, small group plans, and some have shared with us that their brokers are not disclosing information about these plans to current and potential clients. While it’s unclear why this is happening, it is obvious that we need more oversight and education on the full range of available healthcare plans, especially those that provide more financial relief.

A third issue that’s preventing the success of the Option’s small group plans is that Colorado hospitals continue to enjoy a streak of high profits—some of the highest in the nation, according to a recent Hospital Insights Report released by the Colorado Department of Healthcare Policy and Financing. While we recognize the importance of profit, it’s unacceptable that hospitals are taking advantage of Coloradans, including small businesses and their employees.The Division of Insurance must hold hospitals accountable for increasing healthcare affordability and accessibility.   


This is a crucial time to make and enforce laws and rules that will benefit us all. Business owners and employees alike are going bankrupt when they seek lifesaving measures. This shouldn’t be the status quo any longer. 

So this is our call to the Colorado Division of Insurance: Negotiate better healthcare pricing on behalf of Coloradans. Bring insurance carriers, brokers and hospitals to the table and ensure they adhere to the rules and stipulations of the Option’s plans. 

We, along with other business organizations and small business owners in the state, have worked hard for this policy and its thorough implementation, and we want to make sure it is successful for the community members who need it most. We urge the Colorado Division of Insurance to hold brokers, carriers and hospitals accountable.

Lindsey Vigoda, of Denver, is Colorado director and national quality jobs policy director at Small Business Majority.

Angelique Espinoza, of Boulder, is director of policy at Good Business Colorado.

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Lindsey Vigoda, of Denver, is Colorado director and national quality jobs policy director at Small Business Majority.

Angelique Espinoza, of Boulder, is director of policy at Good Business Colorado.