ColoradoColorado law limits plan rules and costs for non-opioid pain drugs
Carriers must keep review rules and costs for certain FDA-approved non-opioid pain drugs no higher than for opioid drugs, while some plans must offer an appropriate alternative starting in 2027.
What it does
For FDA-approved non-opioid drugs used for acute or chronic pain, plans must use no stricter review rules or higher out-of-pocket costs than they use for opioid pain drugs.
Individual and small-group plans must make at least one clinically appropriate non-opioid alternative available starting in 2027; large-employer plans must do so starting in 2028. The state requirement for individual and small-group plans is inoperative if federal rules require the state to pay for it.
The Division of Insurance may use $15,415 for staff services to carry out the act during the 2026–27 state fiscal year.
Argument forPeople with acute or chronic pain could face fewer barriers to choosing an FDA-approved non-opioid drug because plans must keep its review rules and costs no higher than for opioid drugs.
Argument againstSome people in individual or small-group plans may lack a required non-opioid alternative if federal rules require the state to pay for that coverage.
More detail
Carriers that cover prescription drugs must apply no stricter review rules or higher cost-sharing to certain non-opioid pain drugs than to opioid pain drugs. This applies to carriers that provide prescription drug benefits. The non-opioid drug must be FDA-approved to treat or manage acute or chronic pain. The act is scheduled to take effect August 12, 2026, if the legislature adjourns on May 13, 2026. If a referendum petition is filed within the stated period, this requirement takes effect only if voters approve it in November 2026.
Certain health plans must make at least one non-opioid prescription drug available as a clinically appropriate alternative to an opioid prescription drug. This applies to individual and small-group plans and large-employer plans. It does not apply to state employee group benefit plans. For individual and small-group plans, this requirement is inoperative if the insurance division determines federal rules require the state to pay for the coverage. Large-employer plans have no such exception stated here. Coverage may be offered through a high-deductible plan. A carrier may count the deductible unless the U.S. Treasury considers the coverage preventive or finds its deductible acceptable. State employee group benefit plans are excluded. The requirement applies to individual and small-group plans issued or renewed on or after January 1, 2027, and large-employer plans issued or renewed on or after January 1, 2028.
The Division of Insurance may use $15,415 for staff services to carry out the act. The appropriation is to the Department of Regulatory Agencies for use by the Division of Insurance. The money comes from the Division of Insurance cash fund and is based on an estimate that the division will need an additional 0.2 full-time-equivalent position. The appropriation is for the 2026–27 state fiscal year.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Jun 3Governor Jared Polis SignedBecame Law
- May 22Signed by the President of the SenateMajor
- May 22Signed by the Speaker of the HouseMajor
- May 22Sent to the GovernorTo Governor
- May 8Senate Considered House Amendments - Result was to Concur - Repass
- Vote recorded CONCUR. Result: pass.Lower
- Vote recorded REPASS. Result: pass.Lower
- Vote recorded REPASS. Result: pass.Upper
- Vote recorded CONCUR. Result: pass.Upper
- May 6House Third Reading Passed with Amendments - FloorPassed House
- Vote recorded AMD (L.011). Result: pass.Lower
- Vote recorded BILL. Result: pass.Lower
- Vote recorded PERM. Result: pass.Lower
- May 5House Second Reading Special Order - Passed with Amendments - Committee
- May 5House Second Reading Special Order - Passed with Amendments - No Amendments
- May 5House Second Reading Special Order - Lost with Amendments - Committee
- May 1House Committee on Appropriations Refer Amended to House Committee of the WholeMinor
- Vote recorded Refer Senate Bill 26-006, as amended, to the Committee of the Whole. Result: pass.Upper
- Vote recorded Refer Senate Bill 26-006, as amended, to the Committee of the Whole. Result: pass.Lower
- Vote recorded Adopt amendment J.002. Result: pass.Lower
- Apr 22House Committee on Health & Human Services Refer Unamended to AppropriationsMinor
- Vote recorded Refer Senate Bill 26-006 to the Committee on Appropriations. Result: pass.Upper
- Vote recorded Refer Senate Bill 26-006 to the Committee on Appropriations. Result: pass.Lower
- Apr 20Senate Third Reading Passed - No AmendmentsPassed Senate
- Vote recorded BILL. Result: pass.Lower
- Vote recorded BILL. Result: pass.Upper
- Apr 20Introduced In House - Assigned to Health & Human ServicesMinor
- Apr 17Senate Committee on Appropriations Refer Unamended to Senate Committee of the WholeMinor
- Vote recorded Refer Senate Bill 26-006 to the Committee of the Whole. Result: pass.Upper
- Apr 17Senate Second Reading Special Order - Passed with Amendments - Committee
- Apr 8Senate Committee on Health & Human Services Refer Amended to AppropriationsMinor
- Vote recorded Refer Senate Bill 26-006, as amended, to the Committee on Appropriations. Result: pass.Upper
- Vote recorded Adopt amendment L.004 (Attachment E). Result: pass.Upper
- Vote recorded Adopt amendment L.001 (Attachment D). Result: pass.Upper
- Apr 2Senate Committee on Health & Human Services Witness Testimony and/or Committee Discussion Only
- Jan 14Introduced In Senate - Assigned to Health & Human ServicesIntroduced
Healthcare