Colorado Will Soon Expand Insurance Coverage for Abortion

Starting next year, many health insurance carriers in Colorado must pay for abortion coverage without deductibles, copays or co-insurance — and recent federal guidance just expanded that requirement.

State legislators passed Senate Bill 23-189 in 2023, which requires health insurance carriers that serve large employers (those with more than 100 employees) to cover the total cost of abortion care beginning in 2025. Under the bill, health insurance for the small group and individual market would provide abortion coverage depending on how it would affect premiums, with the state having to defray extra costs if the coverage had the potential to increase premiums.

However, on Tuesday, July 23, the Colorado Division of Insurance announced that it received federal confirmation that premiums will not increase and defrayal is not needed. According to the CDI, the state can require individual and small group insurance plans to provide the same coverage for abortion care as large employer plans.

"The Department of Insurance's new guidance means that every Coloradan, regardless of their insurance plan, will soon be able to access abortion care without high cost being a barrier to access," said state Senator Lisa Cutter, a sponsor of the bill, in a statement. "Investing in all aspects of sexual and reproductive health care is the right thing to do, both socially and economically."

Insurance carriers in the individual and small group market must pay for abortion coverage without deductibles, copays or co-insurance beginning on July 24, 2025, though the Division of Insurance encouraged carriers to start providing coverage on January 1, 2025, in an announcement on Tuesday.

When presenting the bill in 2023, sponsor Senator Dafna Michaelson Jenet spoke of her own abortion experience. After more than a year of trying to have a baby, she miscarried at twenty weeks of pregnancy. With no fetal heartbeat, her doctor sent her to a clinic to receive an abortion, saying she was at risk of becoming septic and dying if she continued to carry the baby.

Though she had insurance, Michaelson Jenet said she had to pay $500 up front for the procedure.

"I was privileged enough to pay for my own abortion out-of-pocket, but accessing the life-saving care you need shouldn't be financially out of reach for Coloradans," Michaelson Jenet said in a statement on July 24. "Unlike other states across the nation, Colorado is securing and expanding access to reproductive health care, including abortion and STI treatments, and I'm thrilled that we will see SB23-189's complete implementation soon."

The bill provides exceptions for government employers and employers for whom abortion conflicts with their religious beliefs. The insurance mandates also apply to treatment for HIV and other sexually transmitted diseases.

Senate Bill 23-189 was part of a legislative package that bolstered reproductive health rights in Colorado, making the state among the strongest for abortion access.

This latest update comes as Colorado voters consider solidifying abortion rights even further. A measure on the November ballot asks voters to enshrine the right to abortion in the state constitution and to allow state funds — including Medicaid and state employee health insurance — to be used to pay for abortions.