Cecilia Comerford-Ames

CMS Communications and Marketing Manager

Colorado lawmakers convened in January for the 2026 legislative session,  and affordability is the defining theme shaping debates under the Gold Dome. A persistent state budget deficit, election-year politics, and uncertainty around federal health policy are converging to influence nearly every major issue – from Medicaid and insurance coverage to liability protections, licensure, and artificial intelligence.

For physicians, the session brings a mix of familiar battles and emerging policy questions, with significant implications for patient access and practice sustainability.

Fiscal Constraints Will Drive the Agenda

Colorado entered the session facing a challenging fiscal outlook. Initial projections show an additional $850 million shortfall for FY 2026, with updated forecasts expected mid-session.

Options that helped balance prior budgets are largely exhausted, leaving limited flexibility. Program cuts and constrained spending growth are increasingly likely, and proposals for new investments will face steep scrutiny. Federal changes tied to HR-1, continued Medicaid cost growth, and declining federal support are expected to further strain the state’s budget.

Medicaid and Coverage Stability in Focus

Medicaid is once again a central topic. Governor Polis has proposed a cap on Medicaid budget growth, across-the-board rate decreases, and other cost-containment measures. At the same time, Colorado is building infrastructure to implement HR-1 work requirements, expected to be operational by the end of the year.

Recent experience underscores the stakes. During the public health emergency unwind, approximately 373,000 eligible Coloradans lost Medicaid coverage, contributing to a rise in the uninsured rate in 2023 and 2024. Additional eligibility hurdles could exacerbate access challenges for patients and increase uncompensated care pressures on physicians and hospitals.

The individual insurance market also faces uncertainty. Federal reauthorization of enhanced premium tax credits appears unlikely, putting exchange affordability at risk. While last year’s SB25-290 created stabilization payments for safety-net providers, those funds alone may not offset broader coverage losses.

Maintaining Stability in Liability and Peer Review

Following the passage of non-economic damages cap legislation in 2024, physician advocates will focus on preserving stability in Colorado’s liability environment. A key priority this session is opposing renewed efforts to expand liability by altering the deceptive trade practices impact standard – a proposal that has surfaced for the third consecutive year.

Protecting peer review confidentiality remains equally important. CMS continues its work with Coloradans Protecting Patient Access, legislators, and allied stakeholders to defend peer review processes that are essential to quality improvement and patient safety. Physician engagement will be critical as these protections face ongoing scrutiny.

Sunset Reviews

The reauthorization of the Medical Practice Act is required this session as part of the state mandated sunset review process. As with any sunset review, the process presents both opportunities and risks. Issues to watch include questions about the balance of representation (physician, non-physician) on the Colorado Medical Board and the critical importance of continuing the confidentiality of peer assistance services for physicians that need help. Other sunset reviews will also see action, including the state recommendation to sunset the podiatry board and integrate it into the medical board and expanding licensure portability for internationally trained professionals.

Artificial Intelligence Policy Continues to Evolve

Colorado’s first-in-the-nation artificial intelligence (AI) law, SB24-205, continues to shape national and state-level debates. Designed to address bias in AI systems, the law imposed broad regulatory requirements that have prompted significant concern from stakeholders across industries, including health care.

Efforts to revise or clarify the law stalled last year, even during a special session. A governor-appointed AI task force is now exploring alternative approaches, though it remains uncertain whether consensus legislation will advance this year. Additional AI-related bills are expected, including proposals addressing AI use in health care and a ban on psychotherapy chatbots.

Vaccination Policy and Scope of Practice

Federal vaccination policy changes are driving renewed state-level discussions. In response to the new  Advisory Committee on Immunization Practices (ACIP) recommendations, a bill has been introduced that will allow Colorado providers to consider either the ACIP or the vaccine guidelines from national primary care societies like American Academy of Pediatrics (AAP). CMS continues to partner with Colorado Chooses Vaccines and others to promote science-based information and support access to vaccines that protect community health.

Scope of practice debates will also continue. Safeguarding physician-led, team-based care remains a priority, with the potential for renewed efforts to expand prescription authority for naturopathic providers and other scope changes.

Looking Ahead

With affordability dominating the legislative landscape, this session will test Colorado’s ability to balance fiscal discipline with patient access, physician practice sustainability, and high-quality care. As debates unfold, physician engagement will be essential to ensuring that cost-containment strategies do not undermine either coverage and access, or the long-term viability of medical practice in Colorado.