House Committee of Reference Report
Committee on Health & Human Services
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March 11, 2026
After consideration on the merits, the Committee recommends the following:
HB26-1019 be amended as follows, and as so amended, be referred to the Committee of the Whole with favorable recommendation:
Page 1, Line 1Amend printed bill, strike everything below the enacting clause and
Page 1, Line 2substitute:
Page 1, Line 3"SECTION 1. Legislative declaration. (1) The general
Page 1, Line 4assembly finds and declares that:
Page 1, Line 5(a) Chronic kidney disease and end-stage renal disease impose a
Page 1, Line 6severe health and financial burden on Colorado residents. In 2021, over
Page 1, Line 78,000 Colorado residents were being treated for end-stage renal disease,
Page 1, Line 8with 4,994 of those residents depending on dialysis to stay alive. The
Page 1, Line 9annual insurance costs for chronic kidney disease in Colorado have
Page 1, Line 10reached $457 million with patients paying nearly $58 million
Page 1, Line 11out-of-pocket. According to the centers for disease control and prevention
Page 1, Line 12in the federal department of health and human services, one out of every
Page 1, Line 137 adult Americans has chronic kidney disease, and up to 90% of those
Page 1, Line 14individuals do not know that they have it. The number of individuals who
Page 1, Line 15have chronic kidney disease is disproportionately higher in minority
Page 1, Line 16communities.
Page 1, Line 17(b) Early screening for chronic kidney disease is essential but
Page 1, Line 18currently underutilized in Colorado. Among the 800,206 Coloradans who
Page 1, Line 19have hypertension, diabetes, or both hypertension and diabetes, an
Page 1, Line 20estimated 144,217 individuals likely have advanced, stages four or five,
Page 1, Line 21chronic kidney disease but many remain undiagnosed due to inadequate
Page 1, Line 22screening. Screening is critical because it allows for earlier diagnosis and
Page 1, Line 23cheaper interventions, which prevent the significant rise in cost and strain
Page 1, Line 24on the health-care system that occurs when chronic kidney disease is
Page 1, Line 25diagnosed late and, as a result, is often more advanced.
Page 1, Line 26(c) Early detection through screening is cost-effective and
Page 1, Line 27prevents disease progression. Each comprehensive kidney function
Page 2, Line 1screening test includes serum creatinine, estimated glomerular filtration
Page 2, Line 2rate, and urine albumin-creatinine testing. This modest investment in
Page 2, Line 3preventive care can identify kidney disease at earlier and more treatable
Page 2, Line 4stages.
Page 2, Line 5(d) Without early detection, the financial burden of chronic kidney
Page 2, Line 6disease escalates dramatically as the condition progresses. Patient
Page 2, Line 7out-of-pocket expenses rise from an average of $280 annually for stage
Page 2, Line 8one chronic kidney disease to $10,183 for end-stage renal disease.
Page 2, Line 9(e) The kidney disease prevention and education task force,
Page 2, Line 10established pursuant to House Bill 21-1171, enacted in 2021, conducted
Page 2, Line 11a comprehensive study and identified early detection through accessible
Page 2, Line 12screening as critical to reducing both health complications and the
Page 2, Line 13financial strain of kidney disease on Colorado residents and the Colorado
Page 2, Line 14health-care system.
Page 2, Line 15(2) The general assembly further declares that the purpose of this
Page 2, Line 16act is to:
Page 2, Line 17(a) Implement the recommendations of the kidney disease
Page 2, Line 18prevention and education task force by requiring health insurance
Page 2, Line 19coverage for annual preventive kidney function screening services
Page 2, Line 20without cost-sharing requirements;
Page 2, Line 21(b) Remove financial barriers that currently prevent early
Page 2, Line 22diagnosis of chronic kidney disease, particularly among high-risk
Page 2, Line 23populations with hypertension or diabetes;
Page 2, Line 24(c) Enable timely medical intervention before kidney disease
Page 2, Line 25progresses to costly advanced stages that require dialysis or kidney
Page 2, Line 26transplantation;
Page 2, Line 27(d) Reduce the overall financial burden of kidney disease on
Page 2, Line 28Colorado patients, insurance plans, and state health-care programs
Page 2, Line 29through cost-effective preventive care; and
Page 2, Line 30(e) Improve health outcomes for Colorado residents by facilitating
Page 2, Line 31earlier detection and treatment of chronic kidney disease.
Page 2, Line 32SECTION 2. In Colorado Revised Statutes, 10-16-104, amend
Page 2, Line 33(18)(a)(I) introductory portion; and add (18)(b.8) as follows:
Page 2, Line 3410-16-104. Mandatory coverage provisions - applicability -
Page 2, Line 35rules - legislative declaration - definitions.
Page 2, Line 36(18) Prevention health-care services - legislative declaration
Page 2, Line 37- rules - definitions.
Page 2, Line 38(a) (I) The following policies and contracts that are issued or
Page 2, Line 39renewed in this state must provide coverage for the total cost of the
Page 2, Line 40preventive health-care services specified in subsections (18)(b), (18)(b.3),
Page 2, Line 41and (18)(b.7), and (18)(b.8) of this section:
Page 2, Line 42(b.8) (I) The coverage required by this subsection (18) must
Page 2, Line 43include annual kidney function screening services designed to
Page 3, Line 1identify patients at risk for chronic kidney disease, including
Page 3, Line 2glomerular filtration rate, or "GFR", testing and urine testing
Page 3, Line 3for screening albumin and creatinine levels.
Page 3, Line 4(II) All large employer health benefit plans issued or
Page 3, Line 5renewed in this state on or after January 1, 2027, shall provide
Page 3, Line 6coverage for kidney function screening services.
Page 3, Line 7(III) (A) Except as provided in subsection (18)(b.8)(III)(B) of
Page 3, Line 8this section, and to the extent that such coverage is not in
Page 3, Line 9addition to benefits provided pursuant to the state benchmark
Page 3, Line 10plan required pursuant to 45 CFR 156.111, all individual and
Page 3, Line 11small group health benefit plans issued or renewed in this state
Page 3, Line 12on or after January 1, 2028, shall provide coverage for kidney
Page 3, Line 13function screening services.
Page 3, Line 14(B) Subsection (18)(b.8)(III)(A) of this section is inoperative
Page 3, Line 15and the state shall not assume an obligation for the coverage
Page 3, Line 16required pursuant to subsection (18)(b.8)(III)(A) of this section
Page 3, Line 17if the division determines that the benefit specified in subsection
Page 3, Line 18(18)(b.8)(III)(A) of this section requires state defrayal of the
Page 3, Line 19cost of coverage pursuant to a provision of the federal act,
Page 3, Line 20including 42 U.S.C. sec. 18031 (d)(3)(B) or a successor provision,
Page 3, Line 21and the implementing regulations or the state is otherwise
Page 3, Line 22required to defray the cost of coverage required pursuant to
Page 3, Line 23subsection (18)(b.8)(III)(A) of this section.
Page 3, Line 24(IV) The coverage required by this subsection (18)(b.8) may
Page 3, Line 25be offered through a high deductible plan that would qualify
Page 3, Line 26for a health savings account pursuant to 26 U.S.C. sec. 223;
Page 3, Line 27except that a carrier may apply deductible amounts for the
Page 3, Line 28required coverage if it is not considered by the United States
Page 3, Line 29department of treasury to be preventive or to have an
Page 3, Line 30acceptable deductible.
Page 3, Line 31SECTION 3. In Colorado Revised Statutes, 24-50-605, amend
Page 3, Line 32(1)(f) as follows:
Page 3, Line 3324-50-605. Group benefit plans - specifications - contracts.
Page 3, Line 34(1) (f) The specifications drawn by the director for any group
Page 3, Line 35benefit plans shall must include the mandated coverages required by
Page 3, Line 36section 10-16-104; C.R.S. except that the specifications must not
Page 3, Line 37include coverage for kidney function screening services, as
Page 3, Line 38described in section 10-16-104 (18)(b.8).
Page 3, Line 39SECTION 4. Act subject to petition - effective date. This act
Page 3, Line 40takes effect at 12:01 a.m. on the day following the expiration of the
Page 3, Line 41ninety-day period after final adjournment of the general assembly (August
Page 3, Line 4212, 2026, if adjournment sine die is on May 13, 2026); except that, if a
Page 3, Line 43referendum petition is filed pursuant to section 1 (3) of article V of the
Page 4, Line 1state constitution against this act or an item, section, or part of this act
Page 4, Line 2within such period, then the act, item, section, or part will not take effect
Page 4, Line 3unless approved by the people at the general election to be held in
Page 4, Line 4November 2026 and, in such case, will take effect on the date of the
Page 4, Line 5official declaration of the vote thereon by the governor.".