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January 2026

The 2026 Legislative Session Convenes

Colorado’s 2026 legislative session is officially underway, and lawmakers have returned to the Capitol with affordability front and center.

As the session begins, a persistent state budget deficit, election-year dynamics, and uncertainty around federal health policy are already shaping the tone of debates under the Gold Dome. These pressures are expected to influence nearly every major health care issue this year — from Medicaid and insurance coverage to liability protections, licensure, and artificial intelligence.

For physicians, the session ahead will include both familiar battles and emerging policy questions, with meaningful implications for patient access, physician-led care, and the long-term sustainability of medical practice in Colorado.

Key Themes:

Fiscal Constraints Will Drive the Agenda

Colorado enters the session facing an estimated $850 million shortfall for FY 2026. Efforts to close budget deficits in the past few years leave few favorable options for legislators to balance the books this year as required by the constitution. Existing programs, notably including Medicaid with growing costs, are under a microscope and proposed new bills with a fiscal note will face tough odds of passing.

Medicaid & Coverage Stability in Focus

Protecting Medicaid and commercial coverage remain at the forefront of policy discussions, with proposals and dynamics that could have direct impacts on patient access and care delivery. Notably:

Governor Polis’ proposed controversial cap on Medicaid budget growth (averaging 9% for years) has run into resistance. The state’s own analyses show that legislative programming using one-time pandemic funding helped to drive the current deficit and that Colorado Medicaid growth in most categories is on par with other states. Some are now wisely questioning why sweeping Medicaid cuts are required to balance the budget and how such cuts would harm the state’s most vulnerable while passing more costs onto an already stressed health care system.
Across-the-board provider rate cuts are a real possibility.
Looming end-of-year, HR-1-Medicaid-work requirements may drive up the number of uninsured patients, and will soon move beyond projection as the state must design an effective redetermination system. The track record, under much more favorable circumstances, is not good. During the public health emergency unwind a few years ago, hundreds of thousands of eligible Medicaid patients were inappropriately kicked off the program, driving uninsured rates and uncompensated care.
The individual insurance market faces uncertainty as the likelihood of Congress extending the enhanced premium tax credits fades. Recent data show that initial losses were not as high as initially expected, but the affordability of commercial insurance continues to be a top priority and 2025 legislative efforts to provide stabilization payments for safety-net providers are unlikely to offset broader coverage losses.

Maintaining Stability in Liability and Peer Review

Physician advocates will be focused on preserving recent gains and opposing efforts that could undermine stability:

Key priorities this session:

Opposing renewed attempts to expand liability by altering the deceptive trade practices impact standard
Protecting peer review confidentiality, which remains essential to internal quality improvement and patient safety

Continued physician engagement will be critical as these protections face ongoing scrutiny.

Sunset Reviews are on Deck

Several regulatory and licensing topics are under review through the state’s mandated sunset process:

Sunset highlights include:

Reauthorization of the Medical Practice Act, with important questions about:
- Balance of physician vs. non-physician representation on the Colorado Medical Board
- Continued confidentiality of physician peer assistance services
A state recommendation to sunset the podiatry board and integrate it into the medical board
Efforts to expand licensure portability for internationally trained professionals

Sunset reviews create opportunities — and risks — so physician input will be important.

Artificial Intelligence Policy Continues to Evolve

Colorado’s first-in-the-nation AI law (SB24-205) continues to spark debate about how it can be fixed. A governor-appointed AI task force is exploring alternative approaches but there are concerns about if consensus can be reached and what the impact of broader broad regulatory requirements for these rapidly evolving new technologies will be under any new law. Other AI legislation is expected covering topics like automated utilization review and prior authorization, along with prohibitions on psychotherapy chatbots.

Vaccination Policy

Vaccine policy is at a critical juncture because federal strategies are going against fundamentals in medicine. One bill CMS Council on Legislation supports, (SB26-032) would allow providers to use either ACIP recommendations or vaccine guidelines from national primary care societies (e.g., AAP). CMS continues to partner with Colorado Chooses Vaccines and others to promote science-based information and access.

Physicians must be at the forefront of conversations about vaccination access and patient trust.

If you provide vaccines and are willing to share your experience publicly — with media, policymakers, and patients — we want to hear from you. There is a critical need right now for physicians who can speak directly to patient care realities, particularly those who are fluent in languages other than English, especially Spanish.

Your voice can help ensure patients receive accurate, trusted information and that policy decisions reflect real-world clinical practice. If you are willing to speak on behalf of your patients in a public setting, please respond to this email.

Scope of Practice Developments

CMS will guard against renewed efforts to enable prescriptive authority for naturopathic doctors
Continued emphasis on safeguarding physician-led, team-based care

Looking Ahead

As the 2026 legislative session gets underway, affordability will dominate nearly every major policy discussion at the Capitol. Lawmakers will be weighing difficult fiscal decisions while grappling with the downstream effects on coverage, access to care, and the sustainability of medical practice. Throughout the session, CMS will focus on ensuring that cost-containment strategies do not come at the expense of patients or the viability of physician-led, team-based care. Physician engagement will be essential as these debates unfold and as proposals move quickly through the legislative process.

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Register for Legislative Night: Feb. 11 at the Capitol and University Club

Seasoned in advocacy or just starting out? Our 2026 Legislative Night is for all CMS members who want to get involved.

Join fellow physicians, medical students, and legislators for Legislative Night, beginning with an optional 4 p.m. session at the Capitol, followed by a 5:30 p.m. happy hour at the University Club of Denver. Meet your legislators at this casual, come-and-go reception and learn more about 2026 legislative hot topics.

During the 4 p.m. session at the Capitol, Senator Kyle Mullica and Representative Lindsay Gilchrist will join us to share what to expect in their committees this legislative session. Introductions will be provided by Senator Dafna Michaelson-Jenet, followed by time for photos at the Capitol.

There is no cost to attend and guests are welcome. Appetizers and drinks will be provided, and several parking options are available. This event is sponsored by the Colorado Medical Society and your local medical societies.

COMPAC and the Small Donor Committee need your contributions heading into another active election season and legislative session. Contribute through our secure portal, cms.org/contribute, or on your annual member dues invoice.

Any individual 18 and older can contribute. Contribution limits apply. $50 per year to the SDC; $625 per election cycle to COMPAC. If you think you may have met the contribution limit already, contact [email protected].