Health Care Reform

The passage of the Patient Protection and Affordable Care Act in 2010 created a number of changes in the private and public health insurance system.  The following information is provided by the Boulder County Human Services Department’s website at

Key changes already in place include: Young adults can now remain on their parents’ health insurance until age 26.  Insurers can no longer deny coverage to children with pre-existing conditions or exclude those conditions from a child’s coverage. Beginning in 2014, adults cannot be denied insurance because of a health condition. There are no longer caps on the dollar amount of health benefits people can receive in a single year or over the course of a lifetime. Certain preventive health services, such as annual exams, are free to insured Coloradans.

Beginning January 1, 2014, individuals will be required to have health insurance. There are exemptions to the requirement, including people who have certain religious beliefs, people who are members of a federally recognized tribe or who cannot find an affordable plan. People who are not lawfully present in the United States and people who are incarcerated are also not subject to the mandate. The Internal Revenue Service (IRS) will be responsible for enforcing the requirement.

In order to help people meet the federal requirement to have health insurance, beginning January 1, 2014, two changes will be taking place:  more individuals will be able to qualify for health insurance through Medicaid and a new Health Premium Tax Credit will help lower and middle-income families reduce the costs of buying health insurance when they purchase it through the Connect for Health Colorado Marketplace.

Beginning in January 2014, Medicaid eligibility requirements will expand to 133% of the Federal Poverty Level (FPL) for all individuals. Colorado Medicaid already covers children up to 133% FPL, so the expansion will increase coverage to parents with Medicaid-eligible children and to adults without dependent children.

The expansion means that Coloradans earning up to 133 percent of the Federal Poverty Level (FPL) will be eligible for Medicaid, which is $31,332 per year for a family of four or $15,288 per year for an individual.  Due to standard deductions that will be made to an individual’s or family’s gross income, households earning up to 138% FPL may be eligible ($32,508 for a family of four; $15,864 for an individual).

You can access Colorado PEAK to see if you are currently eligible for Medicaid. Starting on October 1, 2013, you can use Colorado PEAK to see if you qualify for Medicaid under the expansion.

Connect for Health Colorado is a new online health insurance marketplace that will open on October 1, 2013. This marketplace is sometimes referred to as the “health insurance exchange.” Individuals, families and small employers can shop for and buy health insurance through the Connect for Health Colorado website or receive assistance in-person through a Boulder County Health Coverage Guide. Assistance can also be received over the phone from a Connect for Health Colorado Customer Service Center Representative.

  • Connect for Health Colorado:
  • Connect for Health Colorado: 1-855-752-6749 (1-855-PLANS-4-YOU)
  • Boulder County Health Coverage Guide: 303-441-1000
  • Boulder County Housing and Human Services: 303-441-1000
  • Boulder County Healthy Kids: 303-441-1589

Serene Karplus

About the Author: Serene Karplus – is the Executive Director of the Nederland Area Seniors, Inc. (NAS) which assists senior citizens in enhancing their quality of life, enabling them to live a life of respect and honor.  This is accomplished through the facilitation of nutrition, transportation, education, recreation, socialization and outreach programs for all seniors living in the Greater Nederland Area. Serene is a contributor to The Mountain-Ear with her Senior Scene column.