On March 7, 2025, the Colorado State Legislature introduced House Bill 1174, aimed at reforming reimbursement practices for state and small employer group benefit plans. The bill seeks to address the financial burden on individuals covered under these plans by prohibiting healthcare providers from billing patients for any outstanding balances not reimbursed by insurance carriers, aside from applicable in-network coinsurance, copayments, or deductibles.

Key provisions of the bill include a mandate for insurance carriers to provide cost and quality of care information to the state’s commissioner of insurance and the director of the department of personnel, ensuring transparency in healthcare costs. Additionally, the bill establishes a reporting requirement for the director to submit annual savings reports to the governor's office and the state treasurer, detailing any calculated savings in general fund expenditures resulting from the new reimbursement limits.

The legislation also proposes the creation of a health care reimbursement feasibility study cash fund, allocating $500,000 to explore the potential for similar reimbursement limits for group benefit plans offered to school district, higher education, and local government employees. The findings from this study are expected to be reported to the general assembly by January 1, 2028.

Debate surrounding House Bill 1174 has highlighted concerns regarding its potential impact on healthcare providers and the insurance market. Proponents argue that the bill will enhance affordability and access to healthcare for state employees and small business workers, while opponents caution that it may lead to reduced provider participation in these plans, ultimately affecting the quality of care.

The implications of this bill are significant, as it not only aims to alleviate financial pressures on individuals but also seeks to promote accountability and transparency within the healthcare system. As the bill progresses through the legislative process, stakeholders from various sectors will be closely monitoring its developments and potential outcomes.