If there’s any business in America where you’re expected to buy something without knowing the price, it’s health care. Too many of us have been hit with a $500 bill for a routine lab test that costs $50 elsewhere – or faced a staggering charge in the thousands after an unexpected ER visit. Meanwhile, the United States spends almost twice as much on health care as other developed nations, yet consistently ranks near the bottom in life expectancy and preventable illness. We pay more and get less.
The Affordable Care Act attempted to correct long-standing inequities. It banned discrimination against people with preexisting conditions; required coverage for essential benefits such as hospitalization, mental health care, prescriptions, maternity care, 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 offer appeal rights when claims are denied. These protections have saved families from financial catastrophe, even as affordability remains a challenge.
Many Americans question why tax dollars are not used more effectively to support health care. We pay taxes for schools, roads, and emergency services; investing in health throughout one’s life – not just at age 65 – should be intuitive. Instead, government involvement in health care has grown deeply partisan, before and after the ACA’s passage. The contrast between the stable coverage members of Congress enjoy and the instability facing their constituents raises difficult questions about fairness and priorities.
Families are now facing a one-two economic punch: rising health care costs arriving just as many households grapple with reductions in federal food assistance. When health care and nutrition both become less affordable, the strain compounds, especially for families already living on the margins.
Federal decisions directly shape what La Plata County residents 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 it 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 in 2025, a 19% increase in a single year. About 80% of enrollees receive financial assistance, with average subsidized premiums of roughly $138 per month. Without congressional action, the state estimates 75,000 Coloradans could lose coverage in 2026. Statewide uninsured rates, which had dropped to 4.6% in 2023, have already begun rising – particularly among children and working-age adults.
La Plata County is not immune. In 2025, 5,242 residents – about 12.5% of the county – enrolled in marketplace plans, up from 4,806 the year before. Financially assisted enrollees pay about $148 per month; those without subsidies pay roughly $570. And as of FY 2024, more than 22% of county residents rely on Health First Colorado (Medicaid), meaning any shift in costs or eligibility quickly affects household budgets and the broader system.
Local innovation has helped. Peak Health Alliance – a nonprofit purchasing cooperative that began in Summit County – entered southwest Colorado in 2021 at the invitation of Local First and its business members seeking relief from soaring premiums. By negotiating directly with providers and partnering with Elevate Health Plans and Denver Health Medical Plan, Peak helped lower prices, expand networks, and bring $0 primary care and mental health visits to Colorado Option plans. Since entering the market, the cooperative has saved southwest Colorado residents and businesses an estimated $6 million.
Still, navigating health insurance is difficult even for experts. La Plata County Public Health is onboarding two new Connect for Health Colorado Assisters to help residents evaluate coverage options, understand rising premiums, and use tools such as Connect for Health’s new Estimate & Explore, which allows side-by-side plan comparisons. Contact La Plata County Public Health Department at (970) 903-8536 or request an appointment or more information at hilp@lpcgov.org.
Additional support is available through experienced local brokers – Jay Short Insurance, Transparent Insurance Solutions, Hometown Insurance, Mountain West Insurance, and the Leavitt Group – who offer guidance at no cost to residents.
Open Enrollment runs through Jan. 15. To have coverage begin Jan. 1, residents must enroll by Dec. 15.
La Plata County’s health care challenges are part of a larger national crisis, but local knowledge and local solutions matter. Until federal leaders strengthen and stabilize the system, residents must navigate a complex landscape with care – because without our health, we have nothing.
