HB26-1122 • 2026

Mandatory Coverage Hormone Replacement Therapy

The bill requires all health benefit plans in the state and the medicaid program to provide coverage for hormone replacement therapy, as prescribed by licensed physicians, for women who are experienci

Healthcare Labor

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Rep. R. Keltie
Last action: 2026-02-24
Official status: House Committee on Health & Human Services Postpone Indefinitely
Effective date: Not listed

Plain English Breakdown

The official status shows this bill was postponed indefinitely by the House Committee, meaning it has not passed into law yet. The explanation describes what the bill would do if enacted.

Mandatory Coverage for Hormone Replacement Therapy

This bill requires health insurance plans and Medicaid in Colorado to cover hormone replacement therapy prescribed by doctors for women experiencing menopause or perimenopause.

What This Bill Does

Requires all state health benefit plans to cover hormone replacement therapy as defined by the law.
Sets a start date of January 1, 2027, for large employer health insurance plans issued or renewed in Colorado.
Sets a potential start date of January 1, 2028, for individual and small group health insurance plans if federal funding rules allow it.
Requires the state Medicaid program to begin covering this therapy on July 1, 2027.
Prohibits insurers from denying coverage or requiring prior authorization when a doctor prescribes this treatment according to accepted standards.

Who It Names or Affects

Women in Colorado who are experiencing menopause or perimenopause and need hormone replacement therapy.
Large employers offering health insurance plans issued or renewed on or after January 1, 2027.
Individuals and small groups buying health insurance plans issued or renewed on or after January 1, 2028.
The state Medicaid program.

Terms To Know

Hormone replacement therapy: A medical treatment that replaces a hormone the body no longer makes enough of. It may include creams, pills, pellets, or vaginal devices approved by the FDA.
Menopause and perimenopause: Stages in a woman's life when her body stops making certain hormones due to natural aging or other causes.
Prior authorization: A requirement where an insurance company must approve treatment before it is provided. This bill bans this step for hormone replacement therapy.

Limits and Unknowns

Coverage for individual and small group plans will not start in 2028 if the state determines that federal law requires Colorado to pay extra costs.
The entire act may be delayed or canceled if voters sign a petition to put it on the ballot for a public vote.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

L.001

HOU Health & Human Services

Passed [*]

Plain English: This amendment requires most health insurance plans in Colorado to cover hormone replacement therapy for women experiencing menopause or perimenopause.

Large employer health plans must start covering this treatment on January 1, 2027.
Individual and small group health plans must start covering it on January 1, 2028, unless federal rules prevent the state from doing so without extra funding.
Insurance companies cannot deny or limit coverage if a licensed doctor prescribes the treatment using standard medical methods.
The law defines hormone replacement therapy as treatments like creams, pills, pellets, or devices that replace hormones the body no longer makes enough of.

The text does not specify exactly how much patients will pay out-of-pocket for these services.
Coverage for small group plans might be delayed if federal laws require Colorado to share the cost, which is currently unclear.

L.002

HOU Health & Human Services

Passed [*]

Plain English: This amendment adds a new rule requiring Colorado's Medicaid program to cover hormone replacement therapy for women experiencing menopause or perimenopause, starting in July 2027 if federal approval and funding are available.

It creates a new law section (25.5-5-332.5) specifically for the Medicaid program's coverage of hormone replacement therapy.
Coverage would apply to FDA-approved treatments prescribed by doctors for women going through menopause or perimenopause due to aging or other causes.
The requirement only takes effect on July 1, 2027.

This coverage change depends entirely on receiving federal authorization and financial participation from the U.S. government.
The amendment does not explain what happens if federal approval or funding is denied before the start date.

Bill History

2026-02-24 House
House Committee on Health & Human Services Postpone Indefinitely
2026-02-04 House
Introduced In House - Assigned to Health & Human Services

Official Summary Text

The bill requires all health benefit plans in the state and the medicaid program to provide coverage for hormone replacement therapy, as prescribed by licensed physicians, for women who are experiencing menopause or perimenopause.

Coverage for hormone replacement therapy will be implemented for all large employer health benefit plans issued or renewed in this state on or after January 1, 2027. Coverage for hormone replacement therapy will be implemented for all individual and small group health benefit plans issued or renewed in this state on or after January 1, 2028, as long as the state is not required to defray the cost of the coverage of the hormone replacement therapy.

The state medicaid program is required to provide hormone replacement therapy beginning on July 1, 2027.
(Note: This summary applies to this bill as introduced.)

Current Bill Text

Read the full stored bill text

Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED

LLS NO. 26-0559.01 Renee Leone x2695 HOUSE BILL 26-1122
House Committees Senate Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING MANDATORY HEALTH-CARE COVERAGE FOR HORMONE101
REPLACEMENT THERAPY FOR WOMEN.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.)
The bill requires all health benefit plans in the state and the
medicaid program to provide coverage for hormone replacement therapy,
as prescribed by licensed physicians, for women who are experiencing
menopause or perimenopause.
Coverage for hormone replacement therapy will be implemented
for all large employer health benefit plans issued or renewed in this state
HOUSE SPONSORSHIP
Keltie,
SENATE SPONSORSHIP
(None),
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.
on or after January 1, 2027. Coverage for hormone replacement therapy
will be implem ented for all individual and small group health benefit
plans issued or renewed in this state on or after January 1, 2028, as long
as the state is not required to defray the cost of the coverage of the
hormone replacement therapy.
The state medicaid program is required to provide hormone
replacement therapy beginning on July 1, 2027.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 10-16-104, add (31)2
as follows:3
10-16-104. Mandatory coverage provisions - applicability -4
rules - definitions.5
(31) Hormone replacement therapy - definition - rules.6
(a) A S USED IN THIS SUBSECTION (31), UNLESS THE CONTEXT7
OTHERWISE REQUIRES, "HORMONE REPLACEMENT THERAPY":8
(I) MEANS A MEDICAL TREATMENT THAT REPLACES A HORMONE9
THAT AN INDIVIDUAL 'S BODY IS NO LONGER MAKING OR NO LONGER10
MAKING ENOUGH OF , AS DETERMINED BY A PHYSICIAN LICENSED11
PURSUANT TO ARTICLE 240 OF TITLE 12; AND12
(II) MAY INCLUDE PRESCRIBING A CREAM, AN ORAL MEDICATION,13
A PELLET MEDICATION , A VAGINAL DEVICE , OR ANOTHER METHOD14
APPROVED BY THE FDA.15
(b) IN ACCORDANCE WITH SUBSECTION (31)(e) OF THIS SECTION,16
ALL HEALTH BENEFIT PLANS MUST PROVIDE COVERAGE FOR HORMONE17
REPLACEMENT THERAPY FOR A WOMAN WHO IS EXPERIENCING MENOPAUSE18
OR PERIMENOPAUSE AS A RESULT OF NATURAL AGING OR ANY OTHER19
CAUSE, TO BE ADMINISTERED IN THE METHOD , DOSE , AND FREQUENCY20
PRESCRIBED BY A PHYSICIAN LICENSED PURSUANT TO ARTICLE 240 OF21
TITLE 12.22
HB26-1122-2-
(c) A HEALTH BENEFIT PLAN MUST NOT:1
(I) D ENY OR LIMIT HORMONE REPLACEMENT THERAPY THAT IS2
PRESCRIBED IN ACCORDANCE WITH GENERALLY ACCEPTED STANDARDS OF3
CARE FOR THE PRESCRIPTION OF HORMONE REPLACEMENT THERAPY; OR4
(II) REQUIRE PRIOR AUTHORIZATION FOR HORMONE REPLACEMENT5
THERAPY.6
(d) T HE COMMISSIONER SHALL ADOPT RULES CONSISTENT WITH7
AND AS NECESSARY TO IMPLEMENT THIS SUBSECTION (31).8
(e) (I) ALL LARGE EMPLOYER HEALTH BENEFIT PLANS ISSUED OR9
RENEWED IN THIS STATE ON OR AFTER JANUARY 1, 2027, SHALL PROVIDE10
COVERAGE FOR HORMONE REPLACEMENT THERAPY PURSUANT TO THIS11
SUBSECTION (31).12
(II) E XCEPT AS PROVIDED IN SUBSECTION (31)(e)(III) OF THIS13
SECTION, AND TO THE EXTENT THAT SUCH COVERAGE IS NOT IN ADDITION14
TO BENEFITS PROVIDED PURSUANT TO THE STATE BENCHMARK PLAN15
REQUIRED PURSUANT TO 45 CFR 156.111, ALL INDIVIDUAL AND SMALL16
GROUP HEALTH BENEFIT PLANS ISSUED OR RENEWED IN THIS STATE ON OR17
AFTER JANUARY 1, 2028, SHALL PROVIDE COVERAGE FOR HORMONE18
REPLACEMENT THERAPY PURSUANT TO THIS SUBSECTION (31).19
(III) SUBSECTION (31)(e)(II) OF THIS SECTION IS INOPERATIVE, AND20
THE STATE SHALL NOT ASSUME AN OBLIGATION FOR THE COVERAGE21
REQUIRED PURSUANT TO SUBSECTION (31)(e)(II) OF THIS SECTION, IF:22
(A) THE DIVISION DETERMINES THAT THE COVERAGE SPECIFIED IN23
SUBSECTION (31)(e)(II) OF THIS SECTION REQUIRES STATE DEFRAYAL OF24
THE COST OF COVERAGE PURSUANT TO A PROVISION OF THE FEDERAL ACT,25
INCLUDING 42 U.S.C. SEC. 18031 (d)(3)(B) OR A SUCCESSOR PROVISION26
AND THE IMPLEMENTING REGULATIONS; OR27
HB26-1122-3-
(B) THE STATE IS OTHERWISE REQUIRED TO DEFRAY THE COST OF1
COVERAGE REQUIRED PURSUANT TO SUBSECTION (31)(e)(II) OF THIS2
SECTION.3
SECTION 2. In Colorado Revised Statutes, add 25.5-5-332.5 as4
follows:5
25.5-5-332.5. Hormone replacement therapy - federal6
authorization - definition.7
(1) S UBJECT TO FEDERAL AUTHORIZATION AND FEDERAL8
FINANCIAL PARTICIPATION, ON OR AFTER JULY 1, 2027, THE MEDICAL9
ASSISTANCE PROGRAM SHALL INCLUDE HORMONE REPLACEMENT THERAPY10
FOR A WOMAN WHO IS EXPERIENCING MENOPAUSE OR PERIMENOPAUSE AS11
A RESULT OF NATURAL AGING OR ANY OTHER CAUSE, TO BE ADMINISTERED12
IN THE METHOD , DOSE , AND FREQUENCY PRESCRIBED BY A PHYSICIAN13
LICENSED PURSUANT TO ARTICLE 240 OF TITLE 12.14
(2) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE15
REQUIRES, "HORMONE REPLACEMENT THERAPY " HAS THE MEANING SET16
FORTH IN SECTION 10-16-104 (31)(a).17
SECTION 3. Act subject to petition - effective date. This act18
takes effect at 12:01 a.m. on the day following the expiration of the19
ninety-day period after final adjournment of the general assembly (August20
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a21
referendum petition is filed pursuant to section 1 (3) of article V of the22
state constitution against this act or an item, section, or part of this act23
within such period, then the act, item, section, or part will not take effect24
unless approved by the people at the general election to be held in25
November 2026 and, in such case, will take effect on the date of the26
official declaration of the vote thereon by the governor.27
HB26-1122-4-