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Gov. Jared Polis signs Senate Bill 188 on April 14, 2023, which extends protections to individuals who receive, provide or assist in legal abortions or gender-affirming care from from being subjected to criminal prosecution. (Olivia Sun, The Colorado Sun via Report for America)

Access to abortion and gender-affirming care in Colorado will be bolstered by three Democratic bills signed into law Friday by Gov. Jared Polis. They further cement the state’s reputation as a refuge for people in other parts of the country governed by laws that limit when someone can terminate a pregnancy or transition their gender. 

Polis said during a signing ceremony at the state Capitol that he’s proud of Colorado’s “reputation as a beacon of freedom, a beacon of choice, a beacon of individuality.”

The measures were passed by the legislature a year after Polis signed a bill enshrining nearly unfettered abortion access into state law as abortion restrictions proliferate in states with Republican legislatures following the repeal of Roe v. Wade. That 1973 U.S. Supreme Court decision guaranteed a minimal level of abortion access, for nearly five decades before it was overturned in June.

“We pass this legislation today in order to say ‘we see you in Colorado’ and ‘we’ve got your back,’” Sen. Julie Gonzales, a Denver Democrat and lead sponsor of one of the bills, said in an emotional speech before the measures were signed. “Let the passage of these three bills stand as a testament to folks in this state and across the country that Colorado is a beacon for care.”

Here’s what the three new laws do: 

Senate Bill 188 aims to shield people who receive, provide or assist in legal abortions or gender-affirming care in Colorado from being subjected to criminal prosecution or lawsuits initiated in other states. 

The measure comes in response to laws passed in conservative parts of the country, including Texas, Mississippi and Oklahoma, restricting access to abortions or gender-affirming care, which are available in Colorado with little to no legal hurdles. 

Under the new Colorado law, state courts, law enforcement and regulators are barred from recognizing or participating in out-of-state criminal or civil proceedings around abortions or gender-affirming care. 

Additionally, the new law: 

  • Generally prohibits state and local governments from enacting de facto restrictions on access to abortions or gender-affirming care through licensing, permitting, zoning or similar regulations requirements that apply solely to reproductive health care providers. The provision appears aimed at addressing a situation that arose in Pueblo last year where the Pueblo City Council was considering an ordinance that would have blocked an abortion provider from operating in the municipality, including by requiring abortion clinics operating in the city to apply for a license. The ordinance was ultimately indefinitely shelved.
  • Requires that pregnant prisoners are provided with information about abortion access and miscarriage management.

The bill was sponsored by Democratic Sens. Julie Gonzales of Denver and Sonya Jaquez Lewis of Boulder County, as well as Democratic Reps. Meg Froelich of Arapahoe County and Brianna Titone of Arvada.

The measure may face a court challenge for how its sponsors’ changed the definition of “reproductive health care” to add gender-affirming care under the phrase’s umbrella. 

The bill initially sought to shield access to both reproductive health care and gender-affirming care, but Republican opponents cried foul after the legislature’s nonpartisan lawyers warned that the original version of the measure might violate the single-subject rule in Colorado’s constitution that limits bills to dealing with one topic.

The existing definition in state law is: “health care and other medical services related to the reproductive processes, functions, and systems at all stages of life. It includes, but is not limited to, family planning and contraceptive care; abortion care; prenatal, postnatal, and delivery care; fertility care; sterilization services; and treatments for sexually transmitted infections and reproductive cancers.”

The definition in Senate Bill 188 now says: “Reproductive health care means health care and other medical services related to the reproductive processes, functions, and systems at all stages of life. It includes, but is not limited to, family planning and contraceptive care; gender-affirming health care services; abortion care; prenatal, postnatal, and delivery care; fertility care; sterilization services; and treatment for sexually transmitted infections and reproductive cancers.”

Gonzales defended the final version of the bill. “They’re legally protected health care activities,” she said. “Gender-affirming care is reproductive health care and reproductive health care is gender-affirming care.”

But Sen. Bob Gardner, a Colorado Springs Republican, argued on the chamber floor that the measure still may violate the constitution’s single-subject rule. “This amendment presents an interesting way to get around what is a constitutional problem,” he said. “It defines being an apple as being an orange. I hand it to the sponsors of the amendment — this is clever. At some point, using the definitions to get around the common sense of the title absolutely must be subject to challenge and be unconstitutional.”

Tweaks to health insurance policy around abortion, other reproductive health care

Senate Bill 189 is likely the most technical of the three measures signed into law Friday.

The legislation requires large employer plans to cover the cost of abortions without policy deductibles, copayments or coinsurance starting on Jan. 1, 2025. There is an exception for government employers, because the state is prohibited from spending taxpayer dollars on abortions, as well as for employers for whom abortion is against their “sincerely held religious beliefs.”

Additionally, the new law requires health insurance plans issued or renewed after Jan. 1, 2025, that cover counseling, prevention and screening for sexually transmitted infections offer those services without cost sharing, like through a deductible or copay. It also says that the coverage must include HIV prevention drugs.

The new law also: 

  • Studies how to help patients receiving abortion or other reproductive health services who are concerned about confidentiality
  • Ensures that the exemption from step therapy and prior health insurance authorization requirements for medicating treating HIV also applies to medications prescribed by any authorized provider, not just pharmacists
  • Includes family planning-related services in the existing state reproductive health care program
  • Modernizes a statute from the 1970s to remove old references to young people needing to be referred by a member of the clergy or a state health worker to access contraception

The bill was sponsored by Senate Majority Leader Dominick Moreno, D-Commerce City, as well as Sen. Lisa Cutter, D-Jefferson County, and Democratic Reps. Dafna Michaelson Jenet of Commerce City and Lorena Garcia of Adams County.

Prohibiting false advertising around abortion, potentially outlawing so-called abortion reversal

Senate Bill 190 is targeted toward anti-abortion pregnancy centers, but would apply to any organization purporting to offer pregnancy services.

Under the law, it would immediately also be considered deceptive advertising to falsely purport to offer abortion services or Plan B, the emergency contraceptive.

Finally, prescribing, offering or facilitating abortion pill reversal will be considered “unprofessional conduct for licensed, registered or certified health care providers” unless by Oct. 1 the Colorado Medical Board, State Board of Pharmacy and the State Board of Nursing, in consultation with each other, find that it’s a “generally accepted standard of practice” to engage in abortion pill reversal.

Some states require abortion providers to tell their patients that they can reverse an abortion, but the American College of Obstetricians and Gynecologists says claims about abortion-reversal treatment “are not based in science” and that reversal procedures are unproven and unethical.

The bill was sponsored by Democratic Sens. Faith Winter of Westminster and Janice Marchman of Loveland, as well as Democratic Reps. Karen McCormick of Longmont and Elisabeth Epps of Denver.

Jesse Paul is a Denver-based political reporter and editor at The Colorado Sun, covering the state legislature, Congress and local politics. He is the author of The Unaffiliated newsletter and also occasionally fills in on breaking news coverage. A...