This bill requires all health insurance plans issued or renewed in Colorado to cover gender-affirming health care when deemed medically necessary, and exempts testosterone prescriptions from certain state monitoring programs. It affirms non-discrimination in insurance coverage and aims to protect patient privacy, especially for transgender and gender-diverse individuals.
Definition of Gender-Affirming Health Care: Includes a broad range of services for treating gender dysphoria, such as:
Hormone therapy
Surgical procedures (facial, chest, and genital)
Mental and behavioral health support
Cosmetic and reconstructive procedures if tied to gender-affirming care
Definition of “Medically Necessary”: A licensed physical or behavioral health care provider determines that a specific service is needed to treat gender dysphoria.
Coverage Mandate: Health insurance plans must cover gender-affirming care without regard to the patient's sex or gender.
Restrictions Prohibited: Insurers may not deny or limit coverage if:
The care is medically necessary, and
It aligns with accepted medical standards of care.
Rulemaking Authority: The Commissioner of Insurance must create rules to implement and enforce this coverage mandate.
SECTION 2–3: Exemption from Prescription Drug Monitoring Program (C.R.S. § 12-280-403 & -404)
Testosterone Exemption: Prescriptions for testosterone will:
Not be tracked under Colorado’s Prescription Drug Monitoring Program (PDMP)
Have existing records blocked from view
This aims to protect patient privacy and avoid misuse of testosterone data in monitoring programs often associated with controlled substances or opioid oversight.
SECTION 4: Safety Clause
Declares the bill urgently necessary for public peace, health, and safety—allowing it to take effect without delay, unless challenged by referendum.
Summary
HB25-1309 requires Colorado health insurers to fully cover medically necessary gender-affirming care and protects privacy around testosterone prescriptions. It reinforces access to a wide range of gender-related services and blocks practices that might otherwise discriminate against transgender individuals or limit their access to healthcare. This bill aligns Colorado law with inclusive, medically accepted standards of care for the treatment of gender dysphoria.
Summary
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 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.
