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Reforma a la salud 2.0: Se radicó ponencia para retomar la discusión en el Senado para el tercer debate
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El pasado 16 de junio de 2025 se radicó ante la Comisión Séptima del Senado la ponencia positiva para el tercer debate de la reforma a la salud 2.0. Este es uno de los proyectos legislativos más esperados por el Gobierno del presidente Gustavo Petro, que busca transformar el sistema de salud colombiano. La radicación de esta ponencia marca un avance importante en el proceso, tras haber pasado con éxito por el segundo debate en la Cámara de Representantes.
No obstante, la reforma 2.0 encara un panorama incierto. Aunque se encuentra en una etapa avanzada, su futuro depende del desarrollo de los próximos debates en el Senado, donde en 2024 se hundió la primera reforma a la salud. La Comisión Séptima del Senado fue el escenario donde la reforma anterior fue rechazada, lo que deja la puerta abierta a un posible desenlace similar en esta ocasión.
La ponencia fue firmada por los senadores Martha Peralta Epieyú, junto a Fabián Díaz, Wilson Arias, Ferney Silva, y Omar de Jesús Restrepo. “Seguiremos comprometidos con la búsqueda de consensos que hagan posible una transformación real de nuestro sistema de salud” destacó la senadora Martha Peralta.
¿Qué propone la reforma a la salud 2.0?
Es clave mencionar que la reforma a la salud 2.0 ya fue aprobada en segundo debate en la Cámara de Representantes, con una votación favorable de 95 votos a favor y 25 en contra. Este avance significativo en la Cámara representa un respaldo considerable al proyecto, que, entre otros aspectos, contempla la transformación de las EPS en Gestoras de Salud y Vida (GSV).
De esta manera, el proyecto tiene como objetivo central sustituir el modelo de salud vigente por uno más público, inclusivo y solidario, con énfasis en la Atención Primaria en Salud (APS). Este enfoque pretende asegurar un sistema más accesible y equitativo, donde las personas tengan acceso a servicios médicos básicos de calidad desde el primer nivel de atención.
Un cambio significativo en la estructura del sistema es la sustitución de las EPS por las Gestoras de Salud y Vida (GSV), entidades públicas, privadas o mixtas encargadas de gestionar los servicios de salud, pero sin manejar directamente los recursos financieros. Esta propuesta busca mejorar la coordinación de la atención y permitir una mayor eficiencia en la gestión de los recursos destinados a la salud pública.
Además, el Ministerio de Salud asumiría un rol central en la administración del sistema, mientras que los gobernadores y alcaldes tendrían mayor responsabilidad en la ejecución de políticas adaptadas a las condiciones territoriales. La reforma también incluye la centralización de los recursos bajo la Administradora de los Recursos del Sistema de Salud (ADRES), que sería responsable de los pagos directos a los prestadores de servicios.
Resistencia política: ¿quiénes se oponen a la reforma?
A pesar de los avances, el camino legislativo de la reforma sigue siendo problemático, especialmente debido a las oposiciones internas dentro del Congreso. Seis congresistas han anunciado su voto negativo frente al proyecto, y otros miembros de la Comisión Séptima ya se han manifestado en contra, lo que podría generar un empate en la votación. En ese caso, según el reglamento del Congreso, el proyecto no pasaría y quedaría archivado.
Los senadores de la oposición, en su mayoría de partidos como Partido Conservador, Centro Democrático y Partido Liberal, argumentan que la reforma no aborda los problemas estructurales del sistema de salud y que el modelo propuesto no ofrece soluciones claras a las dificultades que enfrentan tanto los usuarios como los proveedores de servicios de salud.
Miguel Ángel Pinto, senador del Partido Liberal, quien fue uno de los principales opositores a la reforma del año pasado, expresó que esta nueva propuesta es aún más grave y advirtió que el sistema de salud de los docentes, como prueba piloto, está experimentando graves problemas. Estos comentarios reflejan una fuerte resistencia a los cambios estructurales que propone la reforma.
Avances y perspectivas: el futuro de la reforma
A pesar de la resistencia política, la reforma a la salud 2.0 sigue avanzando, con el apoyo de algunos sectores del Gobierno y el Congreso. El ministerio de Salud, encabezado por Guillermo Alfonso Jaramillo, continúa impulsando el proyecto, confiando en que las medidas de ajuste y las propuestas de consenso permitirán que la reforma continúe su camino hacia la aprobación.
El próximo paso será el tercer debate en el Senado, que podría ser convocado a partir del 20 de julio de 2025, tras el receso legislativo. Si el proyecto supera esta etapa, quedará pendiente el debate en el plenario del Senado para su aprobación final.
Conozca aquí los textos definitivos de la ponencia del tercer debate PL 410 de 2025:
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