Diabetes Prevention & Obesity Treatment Act

2025 Regular Session Introduced by Judy Amabile and 25 co-sponsors

Requires large-group plans to cover evidence-based obesity and prediabetes prevention/treatment, with optional coverage for FDA‑approved anti-obesity medications (GLP‑1s).

Governor Signed

Main purpose

To require coverage of evidence‑based prevention and treatment services for chronic obesity and pre‑diabetes in large‑group employer health plans, and to give employers the option to purchase coverage for FDA‑approved anti‑obesity medications (including at least one GLP‑1), with limited exceptions.

Key provisions

Mandatory coverage (applies to large group health benefit plans issued or renewed in Colorado):

A comparable program to the National Diabetes Prevention Program (DPP)
Medical nutrition therapy
Intensive behavioral or lifestyle therapy (multi‑component, consistent with clinical standards and the USPSTF 5‑A counseling framework)
Metabolic and bariatric surgery (per 2022 specialty guidelines)

Optional drug coverage:

Carriers must offer policyholders the option to purchase coverage for FDA‑approved anti‑obesity medications, including at least one FDA‑approved GLP‑1 receptor agonist
Carriers are not required to offer coverage if expected benefits would not be covered by premiums

Definitions: the bill defines “FDA‑approved anti‑obesity medication,” “FDA‑approved GLP‑1 medication,” “intensive behavioral or lifestyle therapy,” “medical nutrition therapy,” and analogous terms used in the mandate

Rulemaking: Colorado Insurance Commissioner may adopt implementation rules

Medicaid / State plan: the enacted bill does not impose the same mandatory coverage on the Medicaid plan; a provision was added specifying that the Medicaid plan’s schedule of services must not include coverage pursuant to the new mandatory large‑group requirement

Who is affected

Primary: Employers and insurers offering large group health benefit plans in Colorado and their employees/covered members

Secondary: Insurance carriers (rulemaking and plan design), state and local governments insofar as they purchase large group coverage (may voluntarily add drug coverage), and providers of DPP, nutrition therapy, behavioral interventions, bariatric surgery, and anti‑obesity medications

Fiscal and procedural impacts

Final Fiscal Note (enacted bill): no appropriation required; Legislative Council anticipates no net ongoing state expenditure increase. Minimal increased workload for the Division of Insurance (DORA) implementable within existing appropriations.

Earlier (pre‑enactment) fiscal analyses had projected substantial Medicaid costs if Medicaid coverage were required (e.g., an initial estimate of roughly $76.3 million in FY 2025‑26 rising in later years). Those larger cost estimates reflected versions of the bill that applied to Medicaid; the enacted bill narrowed scope, eliminating the projected Medicaid fiscal impact.

Effective date: January 1, 2027 (subject to referendum); Insurance Commissioner may promulgate rules before implementation.

Notes

The statute balances a coverage mandate for prevention and non‑drug treatments with an opt‑in model for anti‑obesity drug coverage and a premium‑cost safeguard for carriers.

The law explicitly includes GLP‑1 drugs in the optional coverage discussion but allows carriers to decline if offering them would not be actuarially feasible.

Bill