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

What This Bill Actually Does

The bill, HB26-1019, adds kidney function screening to Colorado's official list of mandatory preventive health-care services. Right now, if your doctor orders blood and urine tests specifically to check how well your kidneys are functioning, you usually end up paying a deductible or a copay. This bill eliminates that cost-sharing. It requires insurers to cover the total cost of an annual screening, which includes an estimated Glomerular Filtration Rate (GFR) test, a Basic Metabolic Panel (BMP), and a urine test for albumin and creatinine levels.

Why focus specifically on kidneys? The lawmakers sponsoring the bill laid out some stark math drawn from a 2021 state task force. Right now, about one in seven Americans has chronic kidney disease (CKD), and up to 90% don't even know they have it until it becomes a crisis. In Colorado alone, over 800,000 people have hypertension, diabetes, or both—which are the major risk factors. Out of that group, roughly 144,000 individuals likely have advanced, stage 4 or 5 kidney disease that remains completely undiagnosed.

The logic here is purely financial and preventative: catching kidney disease early costs a patient about $208 a year out-of-pocket for monitoring and basic meds. Catching it at end-stage renal failure, where dialysis is required just to stay alive, jumps to over $10,000 a year for the patient and strains the entire health-care system. To ease the transition for insurance carriers, the mandate rolls out in two phases. Large employer health benefit plans (issued or renewed after January 1, 2027) will have to comply first. A year later, on January 1, 2028, the rules kick in for individual and small group plans. There is one major administrative catch: this requirement only goes forward if the state isn't forced to foot the bill under the federal Affordable Care Act's rules regarding state-mandated benefits.

What It Means for You

If you live in Colorado, particularly if you're managing high blood pressure or diabetes, this bill is designed to keep you out of the dialysis chair without punishing your wallet. Right now, you might skip an annual kidney lab because you don't want to pay a $50 copay or chip away at a massive deductible. Under HB26-1019, you'd be able to get these specific, highly effective tests done annually for absolutely zero out-of-pocket cost. In practice, this just looks like a routine blood draw and a standard urine sample during your annual physical.

However, there is an important caveat buried in the state's legislative fiscal note that you need to know about. If you have a High-Deductible Health Plan (HDHP) tied to a Health Savings Account (HSA)—which many Coloradans do to save on taxes—this bill as originally written conflicts with federal law. Under strict IRS rules, an HDHP must charge a deductible before covering most things, or you lose your legal ability to contribute to your tax-advantaged HSA. The state's financial analysts fully expect lawmakers to amend the bill to exclude HDHPs from the zero-dollar requirement so you don't accidentally lose your HSA eligibility. Keep an eye on that if you use an HSA.

Here is what you should do right now:

• Check your latest lab results: Next time you get bloodwork, look to see if your doctor is already ordering a BMP or a GFR. If they aren't, and you have risk factors like hypertension or a family history of kidney issues, ask them to add it to your chart.
• Contact your state representative: If you have strong feelings about health insurance mandates—whether you believe insurers should be forced to cover more preventive care, or you think these mandates drive up your monthly premium costs too much—now is the exact time to email the House Health & Human Services committee members before they take their first vote.

What It Means for Your Business

If you own a business in Colorado and provide health insurance to your employees, this bill is a classic double-edged sword. On one hand, preventive care genuinely keeps your workforce healthier and more productive. Catching an employee's kidney disease at stage 1 rather than stage 5 means fewer sick days, lower long-term medical claims, and avoiding the massive disruption that rigid, multi-day dialysis schedules cause for working professionals. On the other hand, whenever the state legislature mandates that insurers cover a new service at 100%, the cost of providing that service doesn't just disappear—it gets baked right into everyone's monthly premiums.

The timeline for when you will feel this compliance change depends entirely on the size of your company. If you negotiate a large employer health plan, the new coverage requirements will hit your policies issued or renewed on or after January 1, 2027. If you buy a small group health plan (typically defined as having 50 or fewer employees), you get an extra year to prepare; the mandate kicks in for policies renewed on or after January 1, 2028. It is also vital to note that this only applies to fully-insured plans regulated by the Colorado Division of Insurance. If you operate a self-funded ERISA plan, a union plan, or a multi-state corporate benefit plan, this state-level mandate does not apply to your business.

Here are the action items for business owners and HR directors this week:

• Talk to your insurance broker: Reach out and ask them to project how state-mandated preventive additions have historically impacted your specific group's premiums. The state explicitly expects premiums to rise, so start budgeting now for your 2027 or 2028 renewals.
• Review your corporate wellness programs: If your company already incentivizes preventive health screenings or offers wellness points, you might want to highlight kidney health in your next open enrollment. Knowing that this coverage will soon be legally protected from cost-sharing (for standard, non-HSA plans) makes it a great, low-cost perk to promote to your team.

Follow the Money

Mandating 'free' health care always costs someone money, and in this case, the financial ripples hit the state government directly in its capacity as a massive employer. According to the nonpartisan Fiscal Note, ensuring zero-copay kidney screenings will force insurance carriers to raise their premiums to cover the lost copay revenue. For the state's own employee health insurance, this is projected to increase costs by up to $1.2 million per year starting in FY 2027-28.

The state offers insurance to its workforce through carriers like Cigna and Kaiser Permanente. Both insurers estimate that eliminating the patient's share of the cost for these lab tests will shift roughly $730,000 to $1,230,000 onto the plans annually. Ultimately, that burden will be split between state agency budgets (which are funded by taxpayers) and the state employees who pay their share of the monthly premiums. Furthermore, local governments, school districts, and statutory public entities across Colorado will likely see similar proportional increases in their own insurance renewals, though the state's analysts haven't calculated an exact aggregate dollar amount for municipalities yet. Finally, the Colorado Division of Insurance will see a minor workload bump as they review insurer rate and form filings to ensure compliance, but they can handle that with their existing budget.

Where This Bill Stands

HB26-1019 was officially introduced in the House on January 14, 2026, and was immediately assigned to the House Health & Human Services Committee.

Right now, it is waiting to be scheduled for its first committee hearing. Given the general bipartisan interest in preventive healthcare and the manageable fiscal impact, the bill has a very solid trajectory to advance. However, you should fully expect to see an amendment introduced early in the committee process to fix the technical conflict with High-Deductible Health Plans so Coloradans don't lose their HSA tax benefits. If you want to weigh in on this legislation, keep an eye on the legislative calendar—that first committee hearing is your best opportunity to testify in person or submit written public comment.