Ley 100 de 1993: the general social security health system
- Law
Law 100 of 1993 created Colombia's health system with insurers (EPS), providers (IPS) and two schemes: contributory and subsidised.
What it is
Law 100 of 1993 (23 December) created the Comprehensive Social Security System. Its Book II organises the General Social Security Health System (SGSSS): people enrol with a health insurer (EPS), which organises and guarantees a benefits plan, and receive services from health care providers (IPS). Those able to pay contribute through the contributory scheme; the poor and vulnerable population receives a subsidy through the subsidised scheme. It was reformed by, among others, Laws 1122 of 2007 and 1438 of 2011.
Key articles
- Art. 152: purpose of Book II: to establish the SGSSS, its direction, organisation and operation.
- Art. 153 (amended by Law 1438 of 2011, art. 3): principles of the system, such as universality, solidarity, equality, compulsory membership, equity, quality and efficiency.
- Art. 157: there are two kinds of members: the contributory scheme (employees, public servants, pensioners and self-employed people able to pay) and the subsidised scheme (people unable to pay).
- Art. 162: creates the Mandatory Health Plan and provides for gradually unifying the plans of both schemes.
- Art. 177: insurers (EPS) enrol and register members, collect contributions, and organise and guarantee the plan for their members.
- Art. 185: providers (IPS) deliver services to members at their level of care.
- Arts. 202 and 211: define the contributory scheme (a contribution) and the subsidised scheme (a contribution fully or partly subsidised with public or solidarity funds).
In clinical practice
- Doctors almost always work in a provider (IPS), but many coverage and authorisation decisions go through the patient's insurer (EPS).
- The scheme does not change the duty to treat emergencies or the ethical content of the medical act.
- The insurer's administrative barriers are not passed on to the patient (Law 1751, art. 10, letter p).
Status and official text
- Official text checked on 2026-11-05 on funcionpublica.gov.co (Law 100 of 1993, Law 1122 of 2007, Law 1438 of 2011) and secretariasenado.gov.co.
- Main reforms of the health system: Law 1122 of 2007 (changes to direction, financing and provision) and Law 1438 of 2011 (reform centred on primary health care). Statutory Law 1751 of 2015 ranks higher.
- Art. 202 was amended by Law 1607 of 2012 (art. 30); art. 162A was declared unconstitutional; art. 157 has text corrected by Ruling C-458 of 2015.
- Ruling T-760 of 2008 ordered the benefits plan of the contributory and subsidised schemes to be unified. The system changes often: check the text in force.
Test yourself
Think of the answer, then tap the question to see it.
What is the difference between an EPS and an IPS?
The EPS enrols members, collects contributions and organises and guarantees the benefits plan (Law 100, art. 177); the IPS provides the health services directly (art. 185).
Who joins the contributory scheme under art. 157 of Law 100?
People with an employment contract, public servants, pensioners and retirees, and self-employed workers able to pay.
Which laws reformed the Law 100 health system before Statutory Law 1751?
Among others, Law 1122 of 2007 and Law 1438 of 2011.
Connections
Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.
Sources: Ley 100 de 1993, por la cual se crea el sistema de seguridad social integral (Función Pública, Gestor Normativo, 1993); Ley 1122 de 2007, changes to the General Social Security Health System (Función Pública, Gestor Normativo, 2007); Ley 1438 de 2011, por medio de la cual se reforma el Sistema General de Seguridad Social en Salud (Función Pública, Gestor Normativo, 2011).
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Representative model, for educational purposes only.