Colorado’s constitutional right to abortion has kicked in. Now what?

In 2024, Coloradans voted to put abortion rights in the Colorado Constitution and lift a ban on public insurance coverage for abortion care with Amendment 79, which took effect Jan. 1, 2026. So now what?

Karen Middleton is President of Cobalt, a Colorado reproductive rights advocacy organization. At a press briefing last week, she said that just because Amendment 79 has kicked in doesn’t mean the battle for abortion access is over.

“What can we do today, tomorrow, next week and throughout this session, to continue to lead, particularly in these challenging times” said Middleton. “Not just from a federal level. The constraints of the state budget and the forces around us are going to make it increasingly challenging, the role that other states are playing in restricting basic access to healthcare for upwards of half their population. So we continue to be playing an important role, even though it looks like some of those policy boxes have been checked here in Colorado.”

Middleton said that these laws don’t just happen overnight — planning for this moment started many years ago, so planning for the future of abortion access starts now.

“A lot of people wondered, aren’t you done now?” said Middleton. “But what we see are continued threats around the edges, and we’re very concerned. The direction of the US Supreme Court has reaffirmed what we did here in Colorado, but makes it more challenging for what the other states are doing.”

In 2025, Colorado lawmakers passed Senate Bill 25-183, which implemented Amendment 79 and made abortion care eligible for Medicaid reimbursement by expanding the definition of “family-planning-related services” to include abortion. Middleton called this legislation a “national model” for abortion access. She said that one of the biggest barriers to abortion care is affordability, so having insurance cover abortion care is critical for access.

Since this is the first time abortion will be covered under Colorado Medicaid, “we need to have those providers feeling safe and secure and taking Medicaid this year and next year,” said Kiera Hatton Sena, Cobalt’s Political Director. Hatton Sena emphasized that Medicaid reimbursement shapes provider participation, so low reimbursement can force clinics to limit the number of Medicaid patients they can serve or opt out entirely.

“This is incredibly acute for abortion care where providers already face elevated security costs, workforce shortages, and administrative complexities,” said Hatton Sena.

Medicaid coverage alone “does not equal access without the reimbursement rates that reflect the very real cost of care, staff, clinical time, follow up compliance infrastructure,” she said. “Colorado risks creating a legal right that patients cannot practically use.”

Cobalt reported that in early January, the Cobalt Abortion Fund had its first client of the year say they were able to use their Colorado State Medicaid to help cover the cost of their abortion. Now it’s a matter of making sure those services stay funded.

“The larger issue is that we have a significant budget gap here in Colorado, really caused by the federal government withdrawing support, mid-budget, and being able to try to recover from that,” said Middleton. “The legislature’s gonna do everything it can to protect this access. But we remain concerned, as does every area where state funding plays an impact, particularly people who are living in the margins, on the edges, who need state support for their own services.”

Hatton Sena said that both long-term contraception and abortion are types of preventative care that save the state money on medical spending over time.

As the year goes on, organizations like Cobalt will be paying attention to the data about just how many patients in Colorado are able to pay for abortion care with Medicaid. They’ll be paying special attention to abortion access in rural areas of the state, because with fewer providers, longer travel distances, and more limited infrastructure, those provider incentives matter even more.

“As we’re here in the post-Dobbs era, Colorado is being watched. We are setting the tone for the country on how to best provide abortion care,” said Hatton Sena. “How the state continues to implement abortion coverage will shape whether or not constitutional protections coexist within a safe functioning healthcare system. That adequate funding sends a very clear signal to patients, providers in other states that abortion access can be both protected and fully operational.”

“Ultimately, our success is gonna be measured by our outcomes, not our intent. That will include provider participation, geographic coverage, wait times or lack thereof, and patient’s ability to use their access to ensure timely care. This is the true difference between a constitutional right and a lived reality.”

This story aired on the Morning Magazine, KGNU’s weekday morning show featuring in-depth discussions on local news issues. Click here to listen to other episodes of the Morning Magazine.