Medicaid Expansion in Colorado: Health First Colorado & ACA Subsidies
- Colorado expanded Medicaid in 2014, meaning adults with household income up to 138% of the Federal Poverty Level (FPL) can qualify for Health First Colorado.
- For a single person in 2026, 138% FPL is an annual income of $20,783; for a family of four, it is $43,056.
- Individuals and families above 138% FPL (and up to 400%+ FPL) may qualify for significant subsidies (Premium Tax Credits) through Connect for Health Colorado, the state's marketplace.
- Pregnant women in Colorado are eligible for Health First Colorado up to 138% FPL, or Child Health Plan Plus (CHP+) up to 195% FPL.
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Understanding Colorado's Expanded Medicaid Program
Colorado's decision to expand Medicaid under the Affordable Care Act (ACA) significantly altered the landscape of health insurance for its low-income residents. This expansion extended eligibility for Health First Colorado (the state's Medicaid program) to nearly all adults with household incomes up to 138% of the Federal Poverty Level (FPL). This means that individuals and families who previously would not have qualified for Medicaid can now receive comprehensive health coverage, including doctor visits, hospital stays, prescription drugs, mental health services, and more, at very low or no cost. This expansion effectively eliminates the "coverage gap" that exists in non-expansion states, where individuals earn too much for Medicaid but too little to qualify for ACA marketplace subsidies.Income and Eligibility for Health First Colorado and ACA Subsidies
Your household income, relative to the Federal Poverty Level (FPL), is the primary factor determining your eligibility for Health First Colorado or financial assistance on Connect for Health Colorado. The FPL is a set of income thresholds issued annually by the federal government.2026 Federal Poverty Level (FPL) Table for Colorado
| Household Size | 100% FPL | 138% FPL | 150% FPL | 200% FPL | 250% FPL | 400% FPL |
|---|---|---|---|---|---|---|
| 1 person | $15,060 | $20,783 | $22,590 | $30,120 | $37,650 | $60,240 |
| 2 people | $20,440 | $28,207 | $30,660 | $40,880 | $51,100 | $81,760 |
| 3 people | $25,820 | $35,632 | $38,730 | $51,640 | $64,550 | $103,280 |
| 4 people | $31,200 | $43,056 | $46,800 | $62,400 | $78,000 | $124,800 |
| 5 people | $36,580 | $50,480 | $54,870 | $73,160 | $91,450 | $146,320 |
| 6 people | $41,960 | $57,905 | $62,940 | $83,920 | $104,900 | $167,840 |
| 7 people | $47,340 | $65,329 | $71,010 | $94,680 | $118,350 | $189,360 |
| 8 people | $52,720 | $72,754 | $79,080 | $105,440 | $131,800 | $210,880 |
| +1 additional | +$5,380 | +$7,424 | +$8,070 | +$10,760 | +$13,450 | +$21,520 |
Source: HHS 2025 Federal Poverty Guidelines (applied to 2026 ACA plan year). Figures apply to the 48 contiguous states + DC.
Below 138% FPL: You will likely qualify for Health First Colorado (Medicaid). For a single person, this means an annual income of approximately $20,783 or less. Medicaid provides comprehensive coverage at little to no cost. 138% - 400%+ FPL: You will likely qualify for Advanced Premium Tax Credits (APTC) through Connect for Health Colorado. APTC helps lower your monthly premium. The amount of the subsidy is based on your income, household size, and the cost of the benchmark Silver plan in your area. 100% - 250% FPL: In addition to APTC, you may also be eligible for Cost-Sharing Reductions (CSRs) if you choose a Silver plan on the marketplace. CSRs reduce your out-of-pocket costs like deductibles, copayments, and coinsurance, making your plan significantly more affordable when you use care.Recommended Plan Tiers Based on Income in Colorado
Choosing the right metal tier (Bronze, Silver, Gold, Platinum) depends heavily on your income and expected healthcare usage. Here's a general guide for Colorado residents:| Income Level | FPL % | Recommended Tier | Monthly Net Premium | Why |
|---|---|---|---|---|
| Under $20,783 (1 person) | Under 138% FPL | Health First Colorado (Medicaid) | ~$0 | Eligible for Colorado's expanded Medicaid program; comprehensive benefits at little to no cost. |
| $20,783–$22,590 (1 person) | 138–150% FPL | Silver (CSR Tier 1) | ~$0–$30 | Highest level of Cost-Sharing Reductions (CSRs) makes deductibles and OOP max very low; often results in near $0-premium after APTC. |
| $22,590–$30,120 (1 person) | 150–200% FPL | Silver (CSR Tier 2) | ~$30–$100 | Significant CSRs still apply, reducing out-of-pocket costs below standard Silver plans; excellent value. |
| $30,120–$37,650 (1 person) | 200–250% FPL | Silver (CSR Tier 3) or Gold | ~$100–$200 | Moderate CSRs on Silver plans; Gold plans may be a good option if you expect high medical use and prefer lower deductibles. |
| $37,650–$60,240 (1 person) | 250–400% FPL | Gold or HDHP | Varies | No CSRs available. Gold plans offer lower deductibles. High Deductible Health Plans (HDHPs) paired with an HSA can be tax-advantageous for healthy individuals. |
| Above $60,240 (1 person) | Above 400% FPL | HDHP+HSA (on or off-exchange) | Varies | Reduced or no APTC. HDHP + HSA offers triple tax advantages (pre-tax contributions, tax-free growth, tax-free withdrawals for qualified medical expenses). |
Net premium after APTC for a single adult, benchmark Silver reference. Actual premium varies by plan and individual circumstances. For households with more than one person, FPL percentages and income thresholds adjust accordingly.
Special Considerations for Pregnant Women and Children in Colorado
Colorado offers robust support for pregnant women and children through its public health programs. This is particularly important because pregnancy itself is not a qualifying life event (QLE) for a Special Enrollment Period (SEP) under the ACA, meaning you cannot enroll in a new marketplace plan just because you become pregnant outside of Open Enrollment. Pregnant Women: In Colorado, pregnant women with household income up to 138% FPL are eligible for comprehensive coverage through Health First Colorado. For those with slightly higher incomes, up to 195% FPL, Colorado's Child Health Plan Plus (CHP+) provides comprehensive prenatal, delivery, and postpartum care. These programs ensure access to vital care throughout pregnancy and after birth. You can apply for these programs through Colorado PEAK (colorado.gov/PEAK). Children: Children in Colorado are eligible for Child Health Plan Plus (CHP+) if their household income is up to 260% FPL. This program provides essential health and dental care, ensuring children have access to necessary medical services as they grow. The birth of a baby is a Qualifying Life Event (QLE), triggering a 60-day Special Enrollment Period to add the newborn to an existing marketplace plan or enroll the family in a new plan. This enrollment can be retroactive to the baby's birth date.Health Insurance in Colorado: What Residents Need to Know
Colorado's health insurance market is served by Connect for Health Colorado, a state-based marketplace (SBM). This means Colorado manages its own enrollment platform, distinct from the federal HealthCare.gov. Through Connect for Health Colorado, residents can find a range of plan types, including Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). Unlike some states, PPO plans are widely available on-exchange in Colorado, offered by carriers such as Anthem Blue Cross and Blue Shield and Kaiser Permanente, among others, providing greater flexibility in choosing doctors and hospitals. For those eligible for Health First Colorado (Medicaid), applications are processed through Colorado PEAK. This unified portal allows residents to apply for various state benefits, including Medicaid and CHP+. Colorado's proactive approach to expanding Medicaid and operating its own marketplace ensures that residents have multiple avenues to secure affordable and comprehensive health coverage, tailored to their income and family needs.Steps to Enroll in Colorado Health Coverage
Navigating your health insurance options in Colorado can be straightforward with these steps:- Estimate Your Annual Household Income: Calculate your projected Modified Adjusted Gross Income (MAGI) for the upcoming year. This includes all taxable income and certain deductions. This figure will determine your eligibility for Health First Colorado or ACA subsidies.
- Check Health First Colorado Eligibility: If your income is at or below 138% FPL (e.g., $20,783 for a single person in 2026), apply for Health First Colorado through Colorado PEAK at colorado.gov/PEAK. If you are pregnant or have children, check the higher income thresholds for CHP+.
- Explore Connect for Health Colorado Plans: If your income is above 138% FPL, visit Connect for Health Colorado to compare plans and determine your subsidy eligibility. Pay close attention to the metal tiers (Bronze, Silver, Gold, Platinum) and the associated deductibles and out-of-pocket maximums.
- Select a Plan and Enroll: Choose the plan that best fits your healthcare needs and budget. If eligible for Cost-Sharing Reductions (CSRs), remember these benefits are only available on Silver plans purchased through Connect for Health Colorado.
- Report Life Changes: Notify Connect for Health Colorado or Health First Colorado of any significant changes to your income, household size, or address during the year. This ensures your subsidies or eligibility remain accurate and helps avoid issues at tax time.
Frequently Asked Questions
What is the income limit for Medicaid in Colorado?
In Colorado, adults with household income up to 138% of the Federal Poverty Level (FPL) are eligible for Health First Colorado, the state's Medicaid program. For a single person in 2026, this is an annual income of approximately $20,783 or less. Eligibility thresholds increase with household size.
How does Medicaid expansion in Colorado affect ACA subsidies?
Because Colorado expanded Medicaid, there is no 'coverage gap' for adults. Individuals with income between 100% and 138% FPL qualify for Health First Colorado (Medicaid). For those above 138% FPL, Affordable Care Act (ACA) subsidies (Premium Tax Credits and Cost-Sharing Reductions) are available through Connect for Health Colorado, the state marketplace, to help lower the cost of health insurance.
Can pregnant women in Colorado get Medicaid?
Yes, pregnant women in Colorado can qualify for comprehensive coverage through Health First Colorado (Medicaid) if their household income is at or below 138% FPL. Additionally, Colorado's Child Health Plan Plus (CHP+) covers pregnant women with income up to 195% FPL. Applications can be submitted through Colorado PEAK.
What is the difference between Health First Colorado and CHP+?
Health First Colorado is Colorado's Medicaid program, covering adults, children, and pregnant women with income up to 138% FPL. Child Health Plan Plus (CHP+) is a separate program for children (up to 260% FPL) and pregnant women (up to 195% FPL) who earn too much for Health First Colorado but cannot afford private insurance. Both provide low-cost health coverage.
Are PPO plans available on Connect for Health Colorado?
Yes, Colorado's state-based marketplace, Connect for Health Colorado, offers a variety of plan types, including Health Maintenance Organizations (HMOs), Exclusive Provider Organizations (EPOs), and Preferred Provider Organizations (PPOs). This provides residents with flexibility in choosing a plan that aligns with their preferred provider network.