Cecilia Comerford-Ames

CMS Communications and Marketing Manager

When the 2026 legislative session adjourned on May 13 sine die under the Gold Dome it closed a session where numerous issues were defined less by dramatic headlines and more by high stakes policy decisions that directly affect how medicine is practiced in Colorado.

Much of the work this year lived in the details: legislative sunsets, budget issues, administrative rules, and technical fixes. It is the kind of policymaking that can feel abstract from the outside, but in reality, these decisions shape the cost of care, determine who leads health care teams, and set the rules that govern physicians’ professional lives.

This session, the Colorado Medical Society (CMS) tracked 51 bills and took positions on 36 of them. Through testimony, negotiations, amendments, and – when necessary – blocking harmful proposals outright, CMS advocacy delivered real results for physicians and patients alike.

The cost of medicine: Pressure on patients and physicians

One of the defining themes of the 2026 session was the growing cost of health care – for patients trying to access care and for physicians struggling to deliver it sustainably.

The 2026 budget and beyond

Colorado lawmakers closed a $1.5 billion budget shortfall this year, following last year’s effort to address a $2 billion deficit. Medicaid dominated the debate, now accounting for 37 percent of the state’s operating budget – surpassing education – and projected to grow by 14.9 percent next year.

Lawmakers scrutinized Medicaid closely, citing 101 percent spending growth between 2015 and 2025 despite just 3.1 percent enrollment growth. Concerns over sustainability, mismanagement, and fraud ultimately led to new leadership at the Department of Health Care Policy and Financing. At the same time, federal policy changes threaten to compound the problem. Under H.R. 1, Colorado is projected to lose $10.4 billion in federal Medicaid funding by 2032, driven by reduced federally matched dollars tied to hospital provider fees and new eligibility requirements. Physicians should expect more uninsured patients and increased coverage churn as a result.

Lawmakers understood the effects these cuts will have on access. They rejected Gov. Polis’ proposals to cap Medicaid growth at 5.4 percent (effectively cutting almost $438 million) or impose a 3.9 percent provider rate cut. Instead, the legislature opted to help fill the budget hole by approving a 2 percent across-the-board provider rate cut ($107 million) and reduced Medicaid payments exceeding 85 percent of Medicare down to that level ($4.8 million). These changes land on an already eroded payment baseline, with anesthesiology and radiology among some of the hardest hit specialties, though neonatal intensive care and obstetric services were exempted from some reductions. Legislators also rejected a Polis proposal to eliminate Indirect Medical Education funding, which would have medical education in the state and resulted in a net loss of federal funds.

Finally, lawmakers created a Medicaid Commission to study program growth and long-term sustainability over the interim and report recommendations back to the legislature. The bottom line for physicians is clear: Medicaid cost containment remains a priority, and its effects – lower rates, fewer federal dollars, and growing coverage instability – will continue to be felt in practices across Colorado.

Financing health care: Drawing a line on medical debt

Throughout the 2026 session, legislators focused heavily on affordability, motivated by a shared concern for patients struggling to pay for care. Physicians see those challenges every day – and share lawmakers’ desire to reduce financial barriers that prevent patients from accessing needed treatment.

However, CMS made clear that how reforms are designed matters. One proposal (HB26-1267) sought to address medical debt by shifting financial risk onto physicians, limiting practices’ ability to collect payment for care already delivered in good faith. The approach would have destabilized physician practices – particularly small, independent, and rural practices – and ultimately reduced access to care for the very patients it aimed to help. Strong opposition by CMS helped to defeat this bill. 

Regulatory sunsets: Quiet decisions with lasting impacts

This year’s sunset reviews of the Medical Board and the Division of Professions and Occupations (DPO) carried high stakes for physician regulation in Colorado. Rather than routine renewals, they tested whether long-standing standards for physician-led oversight, due process, and licensure would be preserved. Through sustained advocacy, physicians prevailed.

During the Medical Board Sunset (HB26-1307), CMS blocked proposals that would have altered the composition of the Colorado Medical Board by adding additional non-physician members, safeguarding meaningful physician oversight. Physicians also secured an important due process protection requiring mailed notice if receipt of an emailed complaint notification is not confirmed. CMS also defeated an effort that would have allowed the Board to take action against a physician’s license based on a complaint alone, without investigation.

Equally significant were outcomes in the DPO sunset (HB26-1324). CMS stopped proposals that could have weakened peer assistance program confidentiality, allowed administrative staff to make disciplinary decisions that could affect a physician’s ability to practice, or permitted licensure without established credentialing standards vetted by national and international accrediting bodies.

Building on this work, CMS also secured key amendments to HB26-1431 to ensure licensure portability efforts did not bypass competency requirements critical to patient safety.

Though highly technical, these sunsets reinforced a fundamental principle: medical care in Colorado should remain grounded in strong physician-led oversight, fair process, and clear professional standards focused on patient safety.

Protecting PHYSICIAN-LED health care

Lawmakers addressed several bills this session that went to the heart of who leads care and how patients are protected within Colorado’s evolving health system. These measures tested the state’s commitment to physician led oversight and clear accountability.

CMS successfully opposed HB26-1231, which would have allowed physical therapists to perform sports physicals – preserving appropriate physician oversight for evaluations that can uncover serious, underlying health conditions. Advocacy efforts took a different turn with HB26-1336, which expanded access to pharmacy services. Despite close collaboration with AAP-CO to address patient safety concerns, the bill ultimately passed, reinforcing the need for continued physician engagement as care delivery models expand. Key amendments helped to mitigate some of patient safety issues including ensuring that pharmacists still have an age floor for test and treat (age 5), requiring pharmacists to refer patients under 18 they test and treat back to their primary care physician, and limiting the conditions to flu, COVID, RSV and strep throat.

Medical spas were also an important focus this session. CMS worked with Copic and the Colorado Hospital Association to defeat HB26-1249, which would have allowed non-physician ownership of medical aesthetics corporations, undermining long-standing corporate practice of medicine protections and creating significant downstream liability risks. Work on this issue will continue in the interim. A second proposal, SB26-130, addressing medical spas and deceptive trade practices, was pulled by sponsors after concerns were raised that it would replace existing regulatory enforcement with expanded civil litigation – without meaningfully improving patient safety.

Together, these outcomes reinforced a consistent theme throughout the 2026 session: physician-led care and strong regulatory structures remain essential to protecting patients – even as health care delivery continues to change.

A public health win that protected the science of medicine

Against this challenging backdrop, CMS also helped secure an unambiguous public health victory. Promoting Immunization Access (SB26-032) passed and was signed into law, reinforcing evidence-based medicine and safeguarding patient access to vaccines. For physicians, the law also provides liability protection to those who choose to follow the vaccine schedule set by the state board of health rather than ACIP.

Among many others, CMS partnered with Colorado Chooses Vaccines on this effort, underscoring the importance of physician judgment, scientific integrity, and public confidence in immunization. At a time when misinformation continues to threaten public health, this law reaffirmed Colorado’s commitment to science-driven care.

Artificial intelligence: Narrowing the rules without blocking progress

Artificial intelligence remained one of the most complex and fast-moving policy areas of the 2026 session, as lawmakers worked to rein in emerging technology while avoiding unintended consequences for health care. Physician advocacy focused on fixing flaws in a prior law, protecting patient safety, and preserving room for responsible innovation guided by clinical judgment.

The most significant measure, SB26-189, grew out of a governor-appointed task force and addressed problems created by the state’s 2024 AI law. CMS worked closely with the Colorado Hospital Association to secure critical improvements, including a HIPAA exemption to ensure federal privacy standards continue to govern clinical uses of AI. While concerns remain about provisions such as a three-year limit on the right to cure, the bill was necessary to prevent overly broad consumer protection rules from unintentionally sweeping in legitimate medical applications.

Additional bills tackled more targeted uses of AI. HB26-1139 mandated human oversight for AI-based medical necessity denials, while HB26-1195 imposed restrictions on AI use in psychotherapy services but explicitly exempted physicians. CMS worked to ensure amendments preserved the ability to deliver high quality mental and behavioral health care with appropriate transparency. HB26-1263, regulating conversational AI tools, advanced with HIPAA exemptions and strengthened safety standards for consumer-facing platforms.

Taken together, these measures represent an important step toward thoughtful guardrails – narrowing the rules where needed without blocking innovation that can improve care, support physicians, and benefit patients.

Removing unnecessary barriers

Several bills this session focused on reducing friction in health care delivery, while preserving patient safety and physician accountability – work that directly affects daily practice.

CMS supported SB26-138, which takes meaningful steps to reduce unnecessary administrative burdens across the health care system. By streamlining regulatory requirements, improving oversight of agency rulemaking, and ensuring stakeholder engagement, the bill decreases time navigating bureaucracy and enables more time focused on patient care. Importantly, the bill repeals the state’s mandated two hours of opioid prescribing CME requirement as a condition of physician license renewal. Also, after three years of advocacy, lawmakers also passed SB26-017, establishing a long-sought framework for resolving out of network insurance payment disputes and bringing greater clarity and predictability to payment conflicts.

Lawmakers addressed medical records access through HB26-1414, where collaboration with Copic and hospitals secured key amendments shielding sensitive quality-assurance materials, ensuring these privileged documents remain confidential and immune to discovery.

Finally, the legislature considered several bills related to compounded medications. CMS supported HB26-1262, which aligned Colorado law with federal standards and protected access to essential compounded medical items. In contrast, SB26-066, which would have expanded physician exposure to civil litigation under the Consumer Protection Act for compounded weight loss medications, was defeated.

Together, these outcomes reflect a focus on removing unnecessary barriers while allowing physicians to spend less time navigating administrative hurdles and more time caring for patients.

Advocacy that Delivered

The 2026 legislative session was not defined by a single sweeping bill. It was defined by steady, persistent advocacy across dozens of complex issues, many of them technical, many of them unglamorous, and all of them consequential.

From costs and financing to innovation and physician-led care, CMS advocacy helped shape policy in ways that matter to physicians and patients alike. When the gavel fell at sine die, the result was clear: physician voices mattered, organized medicine made a difference, and patients across Colorado are better off because of it.