Senate Bill 25-183 Preamended

A Bill for an Act

• Page 1, Line 101Concerning coverage for certain pregnancy-related

• Page 1, Line 102services, and, in connection therewith, making an

• Page 1, Line 103appropriation.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

During the 2024 general election, Colorado voters approved Amendment 79, which:

• Repealed the state constitutional amendment prohibiting the use of public funds to pay for abortions; and
• Added a state constitutional amendment recognizing the right to an abortion and prohibiting Colorado state and local governments from denying, impeding, or discriminating against the exercise of that right, including prohibiting health insurance companies from excluding coverage for abortion.

The bill makes conforming changes to state law relating to abortion care as a result of Amendment 79.

Current law requires the executive director of the department of health care policy and financing to authorize medicaid reimbursement for family-planning-related services. The bill expands the definition of "family-planning-related services" to include abortion care. The bill requires the medical services board to include abortion care in the schedule of health-care services available for pregnant persons enrolled in the children's basic health plan.

• This Unofficial Version Includes Committee

• Amendments Not Yet Adopted on Second Reading

• Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 10-16-104, amend (26)(a) and (26)(d); and repeal (26)(f) as follows:

• Page 2, Line 310-16-104.  Mandatory coverage provisions - applicability -

• Page 2, Line 4rules - definitions. (26)  Abortion care - rules - definition. (a) Except

• Page 2, Line 5as provided in subsections (26)(d) and (26)(g) of this section and subject

• Page 2, Line 6to the provisions of subsections (26)(e) and (26)(f) subsection (26)(e)

• Page 2, Line 7of this section, all individual and group health benefit plans issued or

• Page 2, Line 8renewed in this state shall provide coverage for the total cost of abortion care.

• Page 2, Line 9(d)  An employer is not obligated to provide the coverage required

• Page 2, Line 10by this subsection (26) if providing the coverage conflicts with the employer's sincerely held religious beliefs.

• Page 2, Line 11(I)  Providing the coverage conflicts with the employer's sincerely held religious beliefs; or

• Page 2, Line 12(II)  The employer is a public entity prohibited by section 50 of

• Page 2, Line 13article V of the state constitution from using public funds to pay for induced abortions.

• Page 3, Line 1(f)  With respect to individual and small group health benefit plans:

• Page 3, Line 2(I)  The division shall submit to the federal department of health and human services:

• Page 3, Line 3(A)  The division's determination as to whether the benefit

• Page 3, Line 4specified in this subsection (26) is in addition to essential health benefits

• Page 3, Line 5and would be subject to defrayal by the state pursuant to 42 U.S.C. sec. 18031 (d)(3)(B); and

• Page 3, Line 6(B)  A request that the federal department of health and human

• Page 3, Line 7services confirm the division's determination within sixty days after receipt of the division's request for confirmation of the determination.

• Page 3, Line 8(II)  This subsection (26) applies to, and the division shall

• Page 3, Line 9implement the requirements of this subsection (26) for, individual and

• Page 3, Line 10small group health benefit plans issued or renewed in this state upon the earlier of:

• Page 3, Line 11(A)  Twelve months after the federal department of health and

• Page 3, Line 12human services confirms that the coverage specified in this subsection

• Page 3, Line 13(26) does not constitute an additional benefit that requires defrayal by the state pursuant to 42 U.S.C. sec. 18031 (d)(3)(B);

• Page 3, Line 14(B)  Twelve months after the federal department of health and

• Page 3, Line 15human services otherwise informs the division that the coverage in this

• Page 3, Line 16subsection (26) does not require state defrayal pursuant to 42 U.S.C. sec. 18031 (d)(3)(B); or

• Page 3, Line 17(C)  The passage of more than three hundred sixty-five days since

• Page 3, Line 18the division submitted its determination and request for confirmation

• Page 3, Line 19pursuant to subsection (26)(f)(I) of this section, and the federal

• Page 4, Line 1department of health and human services has failed to respond to the

• Page 4, Line 2request within that period, in which case the division shall consider the

• Page 4, Line 3federal department's unreasonable delay a preclusion from requiring defrayal by the state.

• Page 4, Line 4SECTION 2.  In Colorado Revised Statutes, add 25.5-2-106 as follows:

• Page 4, Line 525.5-2-106.  State-funded abortion care.When abortion care

• Page 4, Line 6services are provided in accordance with articles 4, 5, and 6 of

• Page 4, Line 7this title 25.5, the services must be reimbursed by state funds only.

• Page 4, Line 8SECTION 3.  In Colorado Revised Statutes, 25.5-4-412, amend (1) and (2)(a)(IV) as follows:

• Page 4, Line 925.5-4-412.  Family planning services - family-planning-related

• Page 4, Line 10services - rules - definitions. (1)  When family planning services or

• Page 4, Line 11family-planning-related services are provided in accordance with this

• Page 4, Line 12article 4 and articles 5 and 6 of this title 25.5, the executive director of the

• Page 4, Line 13state department shall authorize reimbursement for the services. subject

• Page 4, Line 14to section 50 of article V of the state constitution. The state department,

• Page 4, Line 15any intermediary, or any managed care organization shall reimburse the

• Page 4, Line 16provider of those services. Family planning services and

• Page 4, Line 17family-planning-related services are not subject to policy deductibles, copayments, or coinsurance.

• Page 4, Line 18(2)  As used in this section, unless the context otherwise requires:

• Page 4, Line 19(a)  "Family-planning-related services" means services provided

• Page 4, Line 20in a family planning setting as part of or as a follow-up to a family planning visit, including:

• Page 4, Line 21(IV)  Any other medical diagnosis, treatment, or preventive service

• Page 5, Line 1that is routinely provided pursuant to a family planning visit, including abortion care.

• Page 5, Line 2SECTION 4.  In Colorado Revised Statutes, 25.5-5-329, amend (1)(b)(IV) as follows:

• Page 5, Line 325.5-5-329.  Family planning services - federal authorization

• Page 5, Line 4- rules - definitions. (1)  As used in this section, unless the context otherwise requires:

• Page 5, Line 5(b)  "Family-planning-related services" means services provided

• Page 5, Line 6in a family planning setting as part of or as a follow-up to a family planning visit, including:

• Page 5, Line 7(IV)  Any other medical diagnosis, treatment, or preventive service

• Page 5, Line 8that is routinely provided pursuant to a family planning visit, including abortion care.

• Page 5, Line 9SECTION 5.  In Colorado Revised Statutes, 25.5-8-107, add (1)(a)(VI) as follows:

• Page 5, Line 1025.5-8-107.  Duties of the department - schedule of services -

• Page 5, Line 11premiums - copayments - subsidies - purchase of childhood

• Page 5, Line 12immunizations. (1)  In addition to any other duties pursuant to this article 8, the department has the following duties:

• Page 5, Line 13(a) (VI)  In addition to the items specified in subsections

• Page 5, Line 14(1)(a)(I), (1)(a)(II), (1)(a)(III), and (1)(a)(V) of this section, and any

• Page 5, Line 15additional items approved by the medical services board, on and

• Page 5, Line 16after January 1, 2026, the medical services board shall include

• Page 5, Line 17abortion care in the schedule of health-care services for all enrolled pregnant persons.

• Page 5, Line 18SECTION 6.  In Colorado Revised Statutes, 24-75-109, add

• Page 5, Line 19(1)(a.9) as follows:

• Page 6, Line 124-75-109.  Controller may allow expenditures in excess of

• Page 6, Line 2appropriations - limitations - appropriations for subsequent fiscal

• Page 6, Line 3year restricted - repeal. (1)  For the purpose of closing the state's books,

• Page 6, Line 4and subject to the provisions of this section, the controller may, on or

• Page 6, Line 5after May 1 of any fiscal year and before the forty-fifth day after the close

• Page 6, Line 6thereof, upon approval of the governor, allow any department, institution,

• Page 6, Line 7or agency of the state, including any institution of higher education, to

• Page 6, Line 8make an expenditure in excess of the amount authorized by an item of appropriation for such fiscal year if:

• Page 6, Line 9(a.9)  The overexpenditure is by the department of health

• Page 6, Line 10care policy and financing for abortion care services provided pursuant to section 25.5-2-106 and 25.5-8-107 (1)(a)(VI); or

• Page 6, Line 11SECTION 7.  In Colorado Revised Statutes, repeal 25.5-3-106, 25.5-4-415, and 25.5-5-103 (2).

• Page 6, Line 12SECTION 8.  Severability. If any provision of this act or the

• Page 6, Line 13application of this act to any person or circumstance is held invalid, the

• Page 6, Line 14invalidity does not affect other provisions or applications of the act that

• Page 6, Line 15can be given effect without the invalid provision or application, and to this end the provisions of this act are declared to be severable.

• Page 6, Line 16SECTION 9.  Appropriation - adjustments to 2025 long bill.

• Page 6, Line 17(1)  To implement this act, appropriations made in the annual general

• Page 6, Line 18appropriation act for the 2025-26 state fiscal year to the department of health care policy and financing are adjusted as follows:

• Page 6, Line 19(a)  The general fund appropriation for medical and long-term care

• Page 6, Line 20services for medicaid eligible individuals is decreased by $1,415,236,

• Page 6, Line 21which amount is subject to the "(M)" notation as defined in the annual

• Page 6, Line 22general appropriation act for the same fiscal year;

• Page 7, Line 1(b)  The decrease of the appropriations in subsection (1)(a) of this

• Page 7, Line 2section is based on the assumption that the anticipated amount of federal

• Page 7, Line 3funds received for medical and long-term care services for medicaid eligible individuals will decrease by $1,576,048.

• Page 7, Line 4(c)  The general fund appropriation for children's basic health plan medical and dental costs is decreased by $36,669;

• Page 7, Line 5(d)  The cash funds appropriation from the healthcare affordability

• Page 7, Line 6and sustainability fee cash fund created in section 25.5-4-402.5 (5)(a),

• Page 7, Line 7C.R.S., for children's basic health plan medical and dental costs is decreased by $41,650; and

• Page 7, Line 8(e)  The decrease of the appropriations in subsection (c) of this

• Page 7, Line 9section is based on the assumption that the anticipated amount of federal

• Page 7, Line 10funds received for children's basic health plan medical and dental costs will decrease by $145,449.

• Page 7, Line 11(2)  For the 2025-26 state fiscal year, $2,928,800 is appropriated

• Page 7, Line 12to the department of health care policy and financing for use for other

• Page 7, Line 13medical services. This appropriation is from the general fund. To

• Page 7, Line 14implement this act, the department may use this appropriation for abortion care.

• Page 7, Line 15SECTION 10.  Effective date. This act takes effect January 1, 2026.

• Page 7, Line 16SECTION 11.  Safety clause. The general assembly finds,

• Page 7, Line 17determines, and declares that this act is necessary for the immediate

• Page 7, Line 18preservation of the public peace, health, or safety or for appropriations for

• Page 7, Line 19the support and maintenance of the departments of the state and state institutions.