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House passes bill requiring coverage and protections for gender-affirming care
Summary
The Colorado House on May 7 repassed House Bill 13‑09, which codifies gender‑affirming health care as covered care and allows a state health affordability enterprise to accept donations to support related services. The measure drew intense debate over minors' access, insurance costs and the role of parental consent before final passage.
The Colorado House repassed House Bill 13‑09 on May 7, a measure that codifies access to gender‑affirming medical and surgical care and directs that health benefit plans cannot deny or limit medically necessary gender‑affirming services.
Proponents said the bill preserves access to care and protects patients from being denied coverage. “This bill makes sure that gender‑affirming care is enshrined into Colorado law so that patients and their doctors, not politicians, are in the driver's seat,” Representative Jennifer Brown said.
Opponents said the bill mandates coverage for procedures they called elective, will raise insurance premiums and lacks safeguards for minors. “You are picking winners and losers in this building,” Representative Mike DeGraaf said. Several members repeatedly urged carve‑outs for minors; an amendment to exclude minors from some procedures failed on the floor.
The bill specifies a list of services considered gender‑affirming care, including behavioral health services, hormone therapy and (for adults) surgical procedures such as chest reconstruction, genital procedures, and certain facial procedures. It also adds language allowing a state entity (the health insurance affordability enterprise) to accept gifts, grants and donations to support the work. The senate amendments that the House concurred with added the donations language.
Supporters cited studies and testimony linking access to gender‑affirming care with reductions in depression and suicidal ideation among transgender adults; backers said the measure is intended to reduce barriers and stabilize coverage for patients already receiving care. Opponents pointed to a lack of an actuarial fiscal estimate in the bill's fiscal note and warned state‑level mandates could push insurers to raise premiums or exit the market.
The House adopted the senate amendments and passed the bill by a 42‑23 vote. Sponsors urged the governor to sign the bill into law; opponents said they would continue to press concerns about minors, parental rights and insurance affordability.
Questions the House raised on the floor included whether the federal Hyde Amendment or future federal rulemaking could affect funding for some services and whether gifts and donations would be sufficient to fund added obligations if insurers changed their participation.
The bill now goes to the governor. Sponsors and critics both indicated they expect further litigation, rulemaking or follow‑up legislation depending on implementation and federal actions.
