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Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 26-0666.01 Eden Rolland x2373 HOUSE BILL 26-1243
House Committees Senate Committees
State, Civic, Military, & Veterans Affairs
A BILL FOR AN ACT
CONCERNING THE REGULATION OF MEDICAL FACILITIES THAT101
PERFORM INDUCED ABORTIONS AFTER THE FIRST TRIMESTER OF102
PREGNANCY.103
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 the department of public health and environment
(department) to annually license, and to establish and enforce standards
for the operation of, facilities that are not currently required to be licensed
by the department and that perform medical or surgical induced abortions
during the second or third trimester of pregnancy.
HOUSE SPONSORSHIP
Bottoms,
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.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. Legislative declaration. (1) The general assembly2
finds that:3
(a) Second- and third-trimester abortion clinics are not currently4
regulated by the Colorado department of public health and environment,5
also referred to as "CDPHE";6
(b) CDPHE is authorized to license, regulate, and inspect a wide7
spectrum of health-care facilities to ensure public health and safety,8
including freestanding emergency departments, critical access hospitals,9
psychiatric hospitals, community clinics, rehabilitation hospitals,10
convalescent centers, facilities for persons with intellectual and11
developmental disabilities, nursing care facilities, hospice care, assisted12
living residences, dialysis treatment clinics, ambulatory surgical centers,13
birthing centers, and home care agencies;14
(c) Gynecologic dilation and curettage, known as a "D&C", and15
second- and third-trimester obstetric D&C, dilation and evacuation,16
dilation and extraction, and inductions of labor are all normally performed17
in facilities regulated by CDPHE. The exception to this protocol is when18
these same procedures are used during an induced abortion at abortion19
clinics in the second and third trimester of a pregnancy.20
(d) Birthing centers, which are licensed, regulated, and inspected21
by CDPHE, are prohibited from inducing labor because of the associated22
risks, but second- and third-trimester abortion clinics routinely use23
labor-inducing drugs without any CDPHE oversight;24
(e) Second- and third-trimester abortion procedures are associated25
with significant risk. There is a 10% risk that a complication will arise26
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during a second-trimester abortion, including cervical laceration,1
hemorrhage, uterine atony, anesthesia complications, uterine perforation,2
disseminated intravascular coagulation, and retained products of3
conception, and more than a 1.5% risk that a severe complication will4
arise, including hospitalization, transfusion, or further surgical5
intervention. The risk from instrument-assisted third-trimester dilation6
and extraction abortions is substantial. Blood loss increases by 7% for7
each additional week of gestational age.8
(f) The risk of dying from an abortion increases 38% for each9
week of gestation after 8 weeks. In the early second trimester, the risk of10
dying from an induced abortion is twice the risk of dying from natural11
childbirth, and it is greater than the risk of dying from procedures12
performed at ambulatory surgical centers in the United States and Canada.13
Birthing centers and ambulatory surgical centers are both regulated by14
CDPHE.15
(g) Within the past year, Colorado became aware of at least one16
maternal death directly attributable to a complication of a17
second-trimester abortion, underscoring the seriousness of these risks and18
the urgent need for oversight; and19
(h) The Colorado Maternal Mortality Review Committee, also20
referred to as the "MMRC", recommends strategies to achieve equity in21
maternal health outcomes and ways to reduce the incidence of22
preventable maternal mortality and morbidity. Pregnancy-associated23
mortality and pregnancy-rela ted maternal mortality include24
abortion-associated mortality and abortion-related maternal mortality. The25
MMRC recommends the use of evidence-based patient safety bundles,26
evidence-based screening tools, and improved coordination of care as key27
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elements to reduce maternal mortality. It is difficult to ensure1
implementation of the MMRC recommendations without a licensing,2
regulation, and inspection process for second- and third-trimester abortion3
clinics.4
(2) Therefore, the general assembly declares that unregulated5
second- and third-trimester abortion clinics place Colorado women's lives6
in jeopardy and should be regulated by CDPHE.7
SECTION 2. In Colorado Revised Statutes, 25-1.5-103, amend8
(1)(a)(I)(A); and add (2)(e) as follows:9
25-1.5-103. Health facilities - powers and duties of department10
- rules - limitations on rules - definitions - repeal.11
(1) The department has, in addition to all other powers and duties12
imposed upon it by law, the powers and duties provided in this section as13
follows:14
(a) (I) (A) To annually license and to establish and enforce15
standards for the operation of general hospitals, hospital units as defined16
in section 25-3-101 (2), freestanding emergency departments as defined17
in section 25- 1.5-114, criti cal access hospitals as defined in section18
25-1.5-114.5, psychiatric hospitals, community clinics, rehabilitation19
hospitals, convalescent centers, facilities for persons with intellectual and20
developmental disabilities, nursing care facilities, hospice care, assisted21
living residences, dialysis treatment clinics, ambulatory surgical centers,22
birthing centers, SECOND- AND THIRD -TRIMESTER ABORTION CLINICS ,23
home care agencies, and other facilities of a like nature, except those24
wholly owned and operated by a governmental unit or agency.25
(2) As used in this section, unless the context otherwise requires:26
(e) "SECOND- AND THIRD-TRIMESTER ABORTION CLINIC" MEANS A27
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FACILITY THAT PERFORMS MEDICAL OR SURGICAL INDUCED ABORTIONS1
AFTER THE FIRST TRIMESTER OF PREGNANCY AND THAT IS NOT OTHERWISE2
PART OF ANOTHER TYPE OF FACILITY REQUIRED TO BE LICENSED BY THE3
DEPARTMENT PURSUANT TO SUBSECTION (1)(a)(I)(A) OF THIS SECTION.4
SECTION 3. Act subject to petition - effective date. This act5
takes effect at 12:01 a.m. on the day following the expiration of the6
ninety-day period after final adjournment of the general assembly (August7
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a8
referendum petition is filed pursuant to section 1 (3) of article V of the9
state constitution against this act or an item, section, or part of this act10
within such period, then the act, item, section, or part will not take effect11
unless approved by the people at the general election to be held in12
November 2026 and, in such case, will take effect on the date of the13
official declaration of the vote thereon by the governor.14
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