It could cause transfers of affiliates to New EPS in several territories of the country.
News Colombia.
The national government issued the Decree 0182 of 2026a rule that redefines the way in which Health Promotion Entities will operate in the country and establishes new rules on their presence in departments and municipalities.
The objective of the measure is to territorially reorganize the health insurance system, defining how many EPS can operate in each area and what minimum percentage of affiliates they must have to remain functioning in a given territory.
With this reorganization, the Government seeks to prevent entities with very few members from existing in certain regions and promote a more balanced distribution of users within the system.
The minimum percentages that the EPS must meet
The decree sets membership requirements depending on the size of the population in each department.
In territories with less than 390,000 inhabitants, each EPS must have at least 15% of the affiliated population. In departments with between 390,000 and 2 million inhabitants, the minimum will be 10%, while in departments with more than 2 million inhabitants the required percentage will be 5%.
For cities and municipalities, it is established that an EPS must have at least 3% of the population affiliated to be able to operate.
In addition, the decree also establishes limits on the number of entities that can operate depending on the size of the municipality. In towns of between 10,000 and 20,000 inhabitants, for example, only one EPS could operate, while in municipalities with between 50,000 and 100,000 inhabitants the maximum would be four.
What will happen to users if their EPS does not meet the requirements?
One of the points that generates the most concern is the possible transfer of affiliates between entities.
If an EPS does not reach the minimum percentages required in a territory or does not meet the conditions to operate there, its users could be transferred to another entity available in that region.
In this scenario, some health sector projections indicate that a significant part of affiliates could end up concentrating on New EPSwhich is currently one of the entities with the highest number of users in the country.
Although the decree does not establish that all citizens must transfer to that EPS, it does allow redistributions of affiliates when it is necessary to reorganize coverage in a territory.
Users warn about the current crisis of the system
The measure has generated concern among patient associations, who consider that structural changes should be implemented when the system has greater stability.
In interview with Caracol News, Alvaro Molinaspokesperson for the Table of Health User Associations, questioned whether the decree is applied amid the difficulties that many patients face in accessing medical services.
The user representative stated that there is currently a critical situation marked by delays in medical appointments, problems in the delivery of medications and an increase in requests, complaints and protections related to health care.
According to Molina, before moving forward with a reorganization of the system, solving the problems that patients experience in their access to services should be prioritized.
The debate about the future of the health system
The decree opens a new chapter in the discussion about the insurance model in Colombia.
While the Government maintains that territorial reorganization will strengthen the provision of services and avoid fragmentation in coverage, user associations and some experts consider that the priority should be to stabilize health care before implementing structural changes.
For now, the Decree 0182 raises a new scenario for the EPS in the country and leaves open the discussion about how affiliates will be redistributed and what impact this reorganization will have on access to medical care for millions of Colombians.
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