(Bloomberg) -- Colombia’s Lower House approved the government’s health-care reform, which seeks to limit the role of the private sector, in a victory for President Gustavo Petro.

The bill approved late Tuesday now moves to the Senate, where it faces two debates before the end of the first half of 2024. Petro’s proposal cuts the role of insurers as intermediaries, with the aim of allowing the government to pay care providers and medical professionals directly.

The government was able to convince Liberal, U Party, and Conservative lawmakers to advance the bill, which had been stuck for weeks after regional elections in October that saw Petro’s allies defeated in all of Colombia’s main cities. Disagreement over the health-care bill earlier this year prompted the president to shake up his cabinet twice. 

If the reform passes in the Senate, it will then be studied by the Constitutional Court. Health-care experts, including former ministers, say it won’t pass that test, arguing it violates fundamental rights by reversing the level of social security protection. 

Some lawmakers, including former allies of Petro, also note that the finance ministry hasn’t given fiscal approval for the reform, which is estimated to cost 53 trillion pesos ($13 billion) through 2030.

With the reform bill facing legislative hurdles, health insurers — including EPS Sanitas and EPS Sura — have accused the government of transferring less per user than required and of not paying past debts. Petro’s administration, however, says it’s fulfilling all its payment obligations. 

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