Text of CO HB 1309 (2025)

First Regular Session Seventy-fifth General Assembly STATE OF COLORADO INTRODUCED LLS NO. 25-0496.01 Brita Darling x2241 HOUSE BILL 25-1309 House Committees Senate Committees Health & Human Services A BILL FOR AN ACT CONCERNING PROTECTING ACCESS TO GENDER-AFFIRMING HEALTH 101 CARE. 102 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.) Under current law, health benefit insurance plans (health benefit plans) include coverage for "gender-affirming health care" as part of individual and group health benefit plans. "Gender-affirming health care" is defined in the bill as supplies, care, and services of a medical, behavioral health, mental health, psychiatric, habilitative, surgical, therapeutic, diagnostic, preventive, rehabilitative, or supportive nature HOUSE SPONSORSHIP Brown and Titone, SENATE SPONSORSHIP Cutter and Gonzales J., Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment. Capital letters or bold & italic numbers indicate new material to be added to existing law. Dashes through the words or numbers indicate deletions from existing law. relating to the treatment of gender dysphoria (gender-affirming health care). The bill codifies gender-affirming health care treatments in statute and prohibits a health benefit plan from denying or limiting medically necessary gender-affirming health care, as determined and prescribed by a physical or behavioral health-care provider (health-care provider). In addition, the bill exempts prescriptions for testosterone from the tracking requirements of the prescription drug use monitoring program and blocks archived records from view. Be it enacted by the General Assembly of the State of Colorado: 1 SECTION 1. In Colorado Revised Statutes, 10-16-104, add (29) 2 as follows: 3 10-16-104. Mandatory coverage provisions - definitions - rules 4 - applicability. (29) Gender-affirming health care - rules - definitions. 5 (a) AS USED IN THIS SUBSECTION (29), UNLESS THE CONTEXT OTHERWISE 6 REQUIRES: 7 (I) "GENDER-AFFIRMING HEALTH CARE" MEANS ALL SUPPLIES, 8 CARE, AND SERVICES OF A MEDICAL, BEHAVIORAL HEALTH, MENTAL 9 HEALTH, PSYCHIATRIC, HABILITATIVE, SURGICAL, THERAPEUTIC, 10 DIAGNOSTIC, PREVENTIVE, REHABILITATIVE, OR SUPPORTIVE NATURE 11 RELATING TO THE TREATMENT OF GENDER DYSPHORIA. 12 "GENDER-AFFIRMING HEALTH CARE" INCLUDES THE FOLLOWING, OR ANY 13 COMBINATION OF THE FOLLOWING: 14 (A) HORMONE THERAPY; 15 (B) BLEPHAROPLASTY, EYE AND LID; 16 (C) FACE, FOREHEAD, OR NECK SKIN TIGHTENING; 17 (D) FACIAL BONE REMODELING; 18 (E) GENIOPLASTY; 19 (F) RHYTIDECTOMY FOR THE CHEEK, CHIN, OR NECK; 20 (G) CHEEK, CHIN, OR NOSE IMPLANTS; 21 HB25-1309 -2- (H) LIP LIFT OR AUGMENTATION; 1 (I) MANDIBULAR ANGLE AUGMENTATION, CREATION, OR 2 REDUCTION; 3 (J) ORBITAL RECONTOURING; 4 (K) RHINOPLASTY; 5 (L) LASER OR ELECTROLYSIS HAIR REMOVAL; 6 (M) BREAST OR CHEST AUGMENTATION, REDUCTION, OR 7 CONSTRUCTION; AND 8 (N) GENITAL AND NONGENITAL SURGICAL PROCEDURES. 9 (II) "MEDICALLY NECESSARY" MEANS A PHYSICAL OR BEHAVIORAL 10 HEALTH-CARE PROVIDER HAS DETERMINED THAT THE PRESCRIBED 11 GENDER-AFFIRMING HEALTH CARE IS NECESSARY FOR THE TREATMENT OF 12 GENDER DYSPHORIA. 13 (b) SUBJECT TO THE REQUIREMENTS SET FORTH IN SUBSECTION 14 (29)(d) OF THIS SECTION, ALL HEALTH BENEFIT PLANS ISSUED OR RENEWED 15 IN THE STATE SHALL PROVIDE COVERAGE FOR GENDER-AFFIRMING HEALTH 16 CARE. THE HEALTH BENEFIT PLAN MUST PROVIDE THE COVERAGE 17 REGARDLESS OF THE COVERED PERSON'S SEX OR GENDER. 18 (c) THE COMMISSIONER SHALL ADOPT RULES CONSISTENT WITH 19 AND AS NECESSARY TO IMPLEMENT THIS SUBSECTION (29). 20 (d) A HEALTH BENEFIT PLAN SHALL NOT DENY OR LIMIT 21 GENDER-AFFIRMING HEALTH CARE THAT IS: 22 (I) MEDICALLY NECESSARY, AS DETERMINED BY THE PHYSICAL OR 23 BEHAVIORAL HEALTH-CARE PROVIDER WHO PRESCRIBES THE 24 GENDER-AFFIRMING HEALTH CARE; AND 25 (II) PRESCRIBED IN ACCORDANCE WITH GENERALLY ACCEPTED 26 STANDARDS OF CARE FOR THE PROFESSION. 27 HB25-1309 -3- SECTION 2. In Colorado Revised Statutes, 12-280-403, add 1 (1.5) as follows: 2 12-280-403. Prescription drug use monitoring program - 3 registration required - applications - rules - appropriation. (1.5) THE 4 REQUIREMENTS OF THIS SECTION DO NOT APPLY TO A PRESCRIPTION FOR 5 TESTOSTERONE. THE DIVISION SHALL BLOCK ARCHIVED TESTOSTERONE 6 PRESCRIPTIONS FROM VIEW. 7 SECTION 3. In Colorado Revised Statutes, 12-280-404, amend 8 (2)(c) as follows: 9 12-280-404. Program operation - access - rules - definitions. 10 (2) (c) (I) EXCEPT AS PROVIDED IN SUBSECTION (2)(c)(II) OF THIS 11 SECTION, the program shall track all controlled substances dispensed in 12 this state. Each pharmacy shall upload all controlled substances dispensed 13 in each pharmacy in accordance with all applicable reporting 14 requirements. 15 (II) THE REQUIREMENTS OF THIS SECTION DO NOT APPLY TO A 16 PRESCRIPTION FOR TESTOSTERONE. THE DIVISION SHALL BLOCK ARCHIVED 17 TESTOSTERONE PRESCRIPTIONS FROM VIEW. 18 SECTION 4. Safety clause. The general assembly finds, 19 determines, and declares that this act is necessary for the immediate 20 preservation of the public peace, health, or safety or for appropriations for 21 the support and maintenance of the departments of the state and state 22 institutions. 23 HB25-1309 -4-

HOUSE BILL 25-1309 BY REPRESENTATIVE(S) Brown and Titone, Bacon, Clifford, Duran, Froelich, Garcia, Gilchrist, Hamrick, Joseph, Lieder, Lindsay, Lindstedt, Mabrey, Martinez, Mauro, McCormick, Paschal, Rutinel, Rydin, Sirota, Smith, Stewart K., Stewart R., Story, Valdez, Velasco, Willford, Woodrow, Zokaie, Boesenecker, Camacho, Espenoza, Lukens, Marshall, McCluskie, Carter; also SENATOR(S) Cutter and Gonzales J., Amabile, Danielson, Exum, Hinrichsen, Kipp, Kolker, Marchman, Michaelson Jenet, Snyder, Sullivan, Wallace, Weissman, Winter F., Coleman. CONCERNING PROTECTING ACCESS TO GENDER-AFFIRMING HEALTH CARE. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, 10-16-104, add (30) as follows: 10-16-104. Mandatory coverage provisions - definitions - rules - applicability. (30) Gender-affirming health care - rules - definitions. (a) AS USED IN THIS SUBSECTION (30), UNLESS THE CONTEXT OTHERWISE REQUIRES: NOTE: This bill has been prepared for the signatures of the appropriate legislative officers and the Governor. To determine whether the Governor has signed the bill or taken other action on it, please consult the legislative status sheet, the legislative history, or the Session Laws. ________ Capital letters or bold & italic numbers indicate new material added to existing law; dashes through words or numbers indicate deletions from existing law and such material is not part of the act. (I) "GENDER-AFFIRMING HEALTH CARE" MEANS ALL SUPPLIES, CARE, AND SERVICES OF A MEDICAL, BEHAVIORAL HEALTH, MENTAL HEALTH, PSYCHIATRIC, HABILITATIVE, SURGICAL, THERAPEUTIC, DIAGNOSTIC, PREVENTIVE, REHABILITATIVE, OR SUPPORTIVE NATURE RELATING TO THE TREATMENT OF GENDER DYSPHORIA. "GENDER-AFFIRMING HEALTH CARE" INCLUDES THE FOLLOWING, OR ANY COMBINATION OF THE FOLLOWING: (A) HORMONE THERAPY; (B) BLEPHAROPLASTY, EYE AND LID; (C) FACE, FOREHEAD, OR NECK SKIN TIGHTENING; (D) FACIAL BONE REMODELING; (E) GENIOPLASTY; (F) RHYTIDECTOMY FOR THE CHEEK, CHIN, OR NECK; (G) CHEEK, CHIN, OR NOSE IMPLANTS; (H) LIP LIFT OR AUGMENTATION; (I) MANDIBULAR ANGLE AUGMENTATION, CREATION, OR REDUCTION; (J) ORBITAL RECONTOURING; (K) RHINOPLASTY; (L) LASER OR ELECTROLYSIS HAIR REMOVAL; (M) BREAST OR CHEST AUGMENTATION, REDUCTION, OR CONSTRUCTION; AND (N) GENITAL AND NONGENITAL SURGICAL PROCEDURES. (II) "MEDICALLY NECESSARY" MEANS A PHYSICAL OR BEHAVIORAL HEALTH-CARE PROVIDER HAS DETERMINED THAT THE PRESCRIBED GENDER-AFFIRMING HEALTH CARE IS NECESSARY FOR THE TREATMENT OF GENDER DYSPHORIA. PAGE 2-HOUSE BILL 25-1309 (b) SUBJECT TO THE REQUIREMENTS SET FORTH IN SUBSECTION (30)(d) OF THIS SECTION, ALL HEALTH BENEFIT PLANS ISSUED OR RENEWED IN THE STATE SHALL PROVIDE COVERAGE FOR GENDER-AFFIRMING HEALTH CARE. THE HEALTH BENEFIT PLAN MUST PROVIDE THE COVERAGE REGARDLESS OF THE COVERED PERSON'S SEX OR GENDER. (c) THE COMMISSIONER SHALL ADOPT RULES CONSISTENT WITH AND AS NECESSARY TO IMPLEMENT THIS SUBSECTION (30). (d) A HEALTH BENEFIT PLAN SHALL NOT DENY OR LIMIT GENDER-AFFIRMING HEALTH CARE THAT IS: (I) MEDICALLY NECESSARY, AS DETERMINED BY THE PHYSICAL OR BEHAVIORAL HEALTH-CARE PROVIDER WHO PRESCRIBES THE GENDER-AFFIRMING HEALTH CARE; AND (II) PRESCRIBED IN ACCORDANCE WITH GENERALLY ACCEPTED STANDARDS OF CARE FOR THE PROFESSION. SECTION 2. In Colorado Revised Statutes, 10-16-1206, amend (1)(f) and (1)(g); and add (1)(h) as follows: 10-16-1206. Health insurance affordability cash fund - creation - repeal. (1) There is created in the state treasury the health insurance affordability cash fund. The fund consists of: (f) All interest and income derived from the deposit and investment of money in the fund; and (g) The federal share of the medical assistance payments received pursuant to section 25.5-4-503 (2); AND (h) GIFTS, GRANTS, OR DONATIONS RECEIVED FROM PRIVATE OR PUBLIC SOURCES. SECTION 3. In Colorado Revised Statutes, 10-16-1207, amend (4)(c.5)(III)(C) and (4)(d); and add (4)(e) as follows: 10-16-1207. Health insurance affordability board - creation - membership - powers and duties - subject to open meetings and public PAGE 3-HOUSE BILL 25-1309 records laws - commissioner rules. (4) The board is authorized to: (c.5) Further recommend, for approval and establishment by the commissioner by rule, additional parameters for implementing the subsidies for state-subsidized individual health coverage plans authorized by this part 12, including that the coverage required pursuant to state-subsidized individual health coverage plans must: (III) For a person who, at the time the person applies for state-subsidized coverage, meets the income requirements to qualify for emergency medical assistance pursuant to section 25.5-5-103 and who is a qualified individual who meets the eligibility criteria established in rule pursuant to subsection (4)(c)(IV) of this section, include coverage that: (C) To the extent possible with available funding, includes cost sharing that is further reduced from subsection (4)(c.5)(III)(B) of this section such that the plan has consumer cost-sharing responsibilities for emergency services equivalent to cost-sharing responsibilities for emergency medical assistance pursuant to section 25.5-5-103; and (d) Establish bylaws, as appropriate and consistent with this part 12, for its effective operation; AND (e) SEEK, ACCEPT, AND EXPEND GIFTS, GRANTS, OR DONATIONS FROM PRIVATE OR PUBLIC SOURCES THAT THE ENTERPRISE MAY USE FOR ANY OF THE PURPOSES SET FORTH IN SECTION 10-16-1205, TO COVER THE COSTS OF ENSURING COMPLIANCE IN THE INDIVIDUAL MARKET WITH THE FEDERAL HYDE AMENDMENT OR A SIMILAR AMENDMENT, AND TO COVER THE COSTS OF ENSURING THAT COLORADANS HAVE ACCESS TO LEGALLY PROTECTED HEALTH-CARE ACTIVITIES, AS DEFINED IN SECTION 12-30-121 (1)(d). THE ENTERPRISE SHALL CONSIDER THE FEASIBILITY OF ALLOCATING GIFTS, GRANTS, OR DONATIONS RECEIVED FROM SPECIFIC LOCALITIES OR DIRECTED TO SPECIFIC LOCALITIES TO BE USED ONLY IN THOSE LOCALITIES. SECTION 4. In Colorado Revised Statutes, 12-280-403, add (1.5) as follows: 12-280-403. Prescription drug use monitoring program - registration required - applications - rules - appropriation. (1.5) THE REQUIREMENTS OF THIS SECTION DO NOT APPLY TO A PRESCRIPTION FOR PAGE 4-HOUSE BILL 25-1309 TESTOSTERONE. THE DIVISION SHALL BLOCK ARCHIVED TESTOSTERONE PRESCRIPTIONS FROM VIEW. SECTION 5. In Colorado Revised Statutes, 12-280-404, amend (2)(c) as follows: 12-280-404. Program operation - access - rules - definitions. (2) (c) (I) EXCEPT AS PROVIDED IN SUBSECTION (2)(c)(II) OF THIS SECTION, the program shall track all controlled substances dispensed in this state. Each pharmacy shall upload all controlled substances dispensed in each pharmacy in accordance with all applicable reporting requirements. (II) THE REQUIREMENTS OF THIS SECTION DO NOT APPLY TO A PRESCRIPTION FOR TESTOSTERONE. THE DIVISION SHALL BLOCK ARCHIVED TESTOSTERONE PRESCRIPTIONS FROM VIEW. SECTION 6. Safety clause. The general assembly finds, determines, and declares that this act is necessary for the immediate PAGE 5-HOUSE BILL 25-1309 preservation of the public peace, health, or safety or for appropriations for the support and maintenance of the departments of the state and state institutions. ____________________________ ____________________________ Julie McCluskie James Rashad Coleman, Sr. SPEAKER OF THE HOUSE PRESIDENT OF OF REPRESENTATIVES THE SENATE ____________________________ ____________________________ Vanessa Reilly Esther van Mourik CHIEF CLERK OF THE HOUSE SECRETARY OF OF REPRESENTATIVES THE SENATE APPROVED________________________________________ (Date and Time) _________________________________________ Jared S. Polis GOVERNOR OF THE STATE OF COLORADO PAGE 6-HOUSE BILL 25-1309