Colombian President Gustavo Petro is continuing to make changes to Colombia’s health system through administrative measures, after two attempts to pass a legislative reform were rejected by Congress.

The latest decision is Decree 0182 of 2026, which centralizes the provision of health services in approximately 45% of the country under the administration of Nueva EPS, a mixed public-private company currently under government intervention. As part of the measure, the insurer would receive 2,84 million reassigned members.

According to the government, the decree seeks to modify the flow of resources within the system so that funds would be paid from the government directly to healthcare providers, such as hospitals and clinics. This change would limit the traditional role of the Entidades Prestadoras de Salud (EPS), the system’s intermediaries, whose reduction has been one of the Petro administration’s key policy goals.

President Petro has publicly defended this approach. In a message posted on the social media platform X, he said that EPS entities “devour 70 trillion pesos annually and demonstrably benefit the wealth of their owners.” The president has also blamed these institutions for the crisis affecting the health sector over the past decade, arguing that during that time “the theft of health resources multiplied, and 117 EPS were liquidated to avoid paying their debts.”

The decree has sparked debate in the media. Some reports, including those published by the outlet Infobae after reviewing the official document, described the measure as a “mass transfer of patients and territorial reorganization of the health system.” However, the Ministry of Health rejected that interpretation and clarified that the measure “does not involve an arbitrary transfer of users, but rather a technical step aimed at correcting structural failures in the insurance model”.

In a statement, the ministry explained that “when an EPS lacks operational or financial capacity in a given territory, the state is authorized to adopt temporary mechanisms to ensure healthcare access for users.” The ministry also stated that the goal of the decree is to guarantee effective, fair, dignified and continuous access to healthcare services across the country, particularly in regions where geographic dispersion and low population density have historically complicated service delivery.

Political and administrative context

The debate comes amid a broader process of administrative interventions within the system. According to reports cited by the newspaper El Colombiano, “over the past three years the government, through the Superintendencia Nacional de Salud, has intervened in seven EPS,” removing their management from private owners and placing them under state-appointed administrators.

The government has used this context to justify administrative measures such as those included in the decree, arguing that several insurers have demonstrated structural operational weaknesses. At the same time, the legislative debate over a comprehensive health reform has not been completely closed. According to the same outlet, the government is still exploring the possibility of reviving the reform bill through an appeal filed by Senator Fabián Díaz. In the meantime, the administration has moved forward with changes through decrees, regulatory resolutions and decisions by the health regulator.

Despite the publication of the decree, its implementation still requires additional administrative steps. According to analysis cited by Infobae, “the transfer of members will not occur automatically, as it depends on the Superintendencia Nacional de Salud issuing administrative acts that update the territorial scope of the EPS”. This means the reorganization of the system could unfold gradually once the required regulatory procedures are completed.