The Colorado House passed House Bill 1309 on April 6, 2025, a statute that codifies a definition of gender‑affirming health care and requires health benefit plans issued or renewed in the state to provide coverage for care deemed medically necessary by a treating clinician.

Sponsors and proponents said the bill ensures equitable access to medically recommended care for transgender and gender‑diverse Coloradans. Representative Tatone, a sponsor, told the chamber: “This bill enshrines medical care for transgender people into state law… I ask for an aye vote because all Coloradans deserve access to life saving care.” Supporters also cited evidence cited on the floor that gender‑affirming care reduces psychological distress and suicide risk.

Opponents raised several themes during floor debate: parental rights and involvement in decisions for minors, the clinical evidence base for puberty blockers and surgery for people under 18, and fiscal impacts on insurance premiums and public programs. Representative Caldwell summarized concerns about coverage for minors and surgical procedures: “...this bill... all health benefit plans have to cover gender affirming care… explain to me why this includes children, and why when we run an amendment that says you must exclude children from these procedures and these health benefit care plans, you voted down that amendment.” Representative Bradley and others highlighted actuarial and fiscal questions on the healthcare and Medicaid side and warned that insurers will likely pass added costs to ratepayers.

Floor discussion returned repeatedly to whether the statute should limit certain services to adults, the state’s role in determining medical necessity, and whether the Department of Regulatory Agencies and insurers would have sufficient standards and safeguards. Proponents argued the bill follows standards of care recommended by major medical associations and would reduce avoidable health crises among transgender people; opponents pushed amendments to restrict coverage for minors and to create more transparency around costs.

On final passage the House adopted HB1309. The bill text includes an exemption to the Prescription Drug Use Monitoring Program for testosterone prescriptions and requires the commissioner to adopt rules implementing the coverage requirement.

Votes at a glance: House Bill 1309 — Adopted on third reading (final passage). (See actions and provenance below for recorded tally and linked transcript excerpts.)

What’s next: The bill assigns rulemaking responsibility to the insurance commissioner and will affect plan terms for insurers that write individual, small-group and large-group coverage in Colorado.