Will Your Health Insurance Cover Free Kidney Tests? A New Bill Says Yes.

The Bottom Line

If you are at risk for kidney disease, your health insurance is about to start covering annual kidney screenings at no out-of-pocket cost to you. This bill requires large employers to add this benefit in 2027, with small businesses and individual plans following in 2028, aiming to catch chronic kidney disease early before it gets expensive and life-threatening.

What This Bill Actually Does

Chronic kidney disease (CKD) is a massive, quiet problem in Colorado. According to state data, one in seven Americans has CKD, but up to 90% of them have no idea. For the roughly 800,000 Coloradans dealing with diabetes, hypertension, or both, the risk is incredibly high. When kidney disease is caught late, the costs skyrocket. The legislation notes that patient out-of-pocket expenses jump from an average of $208 a year in the early stages to over $10,000 annually if they hit end-stage renal disease and need dialysis.

House Bill 26-1019 changes the math on early detection by adding preventive kidney function screenings to the list of mandatory, no-cost healthcare services in Colorado. Under this legislation, state-regulated health insurance plans must provide total-cost coverage for annual kidney screenings for at-risk patients. This means no copays, no coinsurance, and no deductibles for these specific tests.

Based on recommendations from a 2021 state task force, the required coverage includes two specific annual tests:

• Glomerular Filtration Rate (GFR) testing: A blood test that checks how well your kidneys are filtering your blood.
• Urine testing: Specifically looking at albumin and creatinine levels to check for early signs of kidney damage.

The goal is simple: catch CKD early when it is much cheaper and easier to manage with modest interventions. It is important to note that this mandate applies specifically to fully insured plans regulated by the Colorado Division of Insurance. It excludes self-funded corporate plans, Medicare, Medicaid, and notably, the state's own employee health plans.

What It Means for You

If you have a family history of kidney issues, or if you manage high blood pressure or diabetes, this bill removes the financial friction of keeping an eye on your kidney health. Starting as early as January 1, 2027, you will be able to get annual GFR and urine albumin-creatinine tests completely covered by your insurance, without worrying about surprise lab bills. Getting these baseline metrics checked annually could be the difference between catching a treatable issue early or facing a life-altering dialysis schedule down the road. The state notes that kidney disease disproportionately impacts minority communities, making this zero-cost access a significant step for health equity.

The rollout happens in two phases. If you get your insurance through a large employer, your plan will include this mandatory coverage starting in 2027. If you buy your own insurance on the exchange or work for a small business, the requirement kicks in on January 1, 2028. However, you should check your specific policy type—if your company uses a self-funded plan (where the employer pays claims directly rather than buying a traditional policy), they aren't bound by this state mandate.

There is one minor catch to watch out for if you carry a high-deductible health plan (HDHP). While the bill aims for zero out-of-pocket costs, federal law regulates how HDHPs operate. If federal rules dictate that these screenings must apply to your deductible first, your insurer will follow those federal rules. Still, having these specific preventative labs coded as covered essential services generally ensures you won't be paying inflated out-of-network rates. When the time comes, it will be worth asking your doctor to explicitly include these tests during your annual physical.

What It Means for Your Business

As a Colorado employer offering health benefits, the primary impact of this legislation will likely show up in your annual premium renewals. Mandating new, zero-cost coverage typically spreads the cost of those services across the entire risk pool. While early detection of kidney disease saves the healthcare system massive amounts of money in the long run (averting millions in state costs for advanced CKD), adding mandatory labs can cause a slight, short-term bump in insurance premiums. The state’s fiscal analysis notes that local governments and school districts might see increased premiums, and private businesses should expect a similar ripple effect.

The compliance burden falls entirely on the insurance carriers, so you will not need to change your internal HR reporting, overhaul your operations, or file new forms with the state. However, you will want to update your employee benefit guides and highlight this new perk based on the phase-in schedule:

• Large employers (generally those with 50 or more employees) will see these changes in fully insured policies issued or renewed on or after January 1, 2027.
• Small group plans have an extra year, with the mandate taking effect for policies issued or renewed on or after January 1, 2028.

If you run a larger company with a self-funded plan (ERISA), this state law does not apply to you, and you maintain the flexibility to design your own benefits package. That said, as fully insured plans adopt these standard preventative measures, you might want to review your own plan design with your broker. Offering zero-cost kidney screenings could be an inexpensive way to keep your workforce healthy and prevent catastrophic, high-dollar dialysis claims from hitting your self-funded risk pool later on.

Follow the Money

This bill costs the state virtually nothing to implement. The Colorado Division of Insurance will need to review rate and form filings from insurance carriers to ensure they are actually covering these tests without cost-sharing, but the state's fiscal note confirms this can be handled with their existing staff and budget. No new taxpayer money is being appropriated to enforce this law.

The real financial ripple effect happens at the local level. Because the state requires fully insured health plans to absorb the cost of these tests without charging copays or deductibles, insurers will likely bake those expenses into their base premiums. Local governments, school districts, and statutory public entities that buy fully insured plans for their employees are expected to see a slight increase in premium costs, though the state has not estimated the exact dollar amount of that increase. Interestingly, the bill specifically exempts state employee health plans from this requirement, shielding the state budget from those same premium hikes.

Where This Bill Stands

HB26-1019 is currently Signed Into Law. The latest official action came on 05/26/2026: Governor Signed.

That means the legislative process is complete and the bill is now law. The remaining questions are about implementation timing and how agencies, businesses, or local governments respond.