Colorado’s health care exchange, Connect for Health Colorado, is under fire from Republican lawmakers who aim to repeal it. Arnise Balle is pictured at one of the exchange’s call centers, in Denver, Colo.

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As the debate plays out nationally on the fate of the Affordable Care Act, the battle over Colorado’s health care exchange, Connect for Health Colorado, has already begun. On the opening day of the legislative session, Republican state Senate President Kevin Grantham stated that repeal was long overdue.

“It is time for us to shed some of the dead weight of failed government policy,” Grantham said in his opening day speech.

To that end, a repeal bill, known as SB17-003, has been introduced in the GOP-controlled Senate. The bill’s sponsor Sen. Jim Smallwood, R-Douglas County, said the ACA hasn’t worked out as promised in Colorado. There are now “fewer insurance companies, fewer choices of physicians within those insurance companies,” said Smallwood. “And the premiums for those plans have really skyrocketed.”

Smallwood wonders if Colorado would be better off joining the federal exchange, instead of insurance customers continuing to be charged a fee to fund Connect for Health. The way he looks at it, Smallwood doesn’t think that “it could be any worse.”

The repeal bill has little chance of getting through the Democrat-controlled House.

Democratic Gov. John Hickenlooper also supports the state’s exchange. Since embracing Obamacare, the state’s uninsured rate has plummeted from 14 percent to half that. Congressional Republicans say they can come up with a better plan than Obamacare, for cheaper, more consumer-driven health care, but the details of that plan haven’t emerged yet. That’s causes heartburn for Hickenlooper, who told Colorado Matters that residents are voicing concerns.

“As much as they were frustrated and hated the Affordable Care Act, they're very concerned about what Congress is going to make, some kind of shoot from the hip decision,” Hickenlooper said. “And that they're going to end up in a worse place than they are now.”

On a recent January day, demonstrators dropped off thousands of petitions urging U.S. Sen, Cory Gardner, a Republican, to protect their access to insurance. A crowd of hundreds march down 17th Street in downtown Denver in front of Gardner’s office, chanting “no repeal, no repeal!”

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The exchange would end up in a “precarious situation,” said Natalie O’Donnell Wood, a health policy analyst with the progressive nonprofit Bell Policy Center, if efforts to repeal the Affordable Care Act continue "without some measures that would help with replacement.”

Two other groups sweating the future are hospitals and insurers. Hospitals worry if Republicans repeal without an adequate replacement, they’ll see huge financial losses, cuts, and layoffs. The ACA, along with the expansion of Medicaid, has brought financial stability for hospitals, according to the Colorado Hospital Association. Now, as many as eight rural Colorado hospitals could close their doors, according to the group.

“We see all of that at risk, so our concern is making certain that patients have confidence that the hospital will be there, have confidence that they’ll have coverage and they’ll get care at the right time,” said Steven Summer, CEO of CHA.

Charlie Sheffield is executive director of the Colorado Association of Health Plans.

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More than 169,000 Coloradans have signed up for insurance on the individual market during the 2016-2017 open enrollment period, which ends Jan.31. For Charlie Sheffield, executive director of the Colorado Association of Health Plans, concerns are rising daily with “not knowing what potentially could come next.” He said insurers are in the process of submitting 2018 premium rates to the state for review. In the last couple of years, some insurers have left the exchange, and one big one, Colorado HealthOp, even collapsed.

“Market disruption is costly, and the more unknowns that we face, it's going to represent higher costs to the consumers,” Sheffield said. “Because we simply will not know what to expect in kind of this new regulatory regime.”

Meantime, he says everyone is trying to decipher the same signals from DC, including some from President Trump on Twitter. “We're all reading the same tweets,” Sheffield said.