Background Citizen participation in health policy decision-making is an issue of global interest. In Colombia, since 2015, a law ordered the Ministry of Health to establish a technical-scientific and participatory procedure to determine services and technologies that should not be publicly funded. The objective of this research was to explore and understand what factors and rationales influence Colombian citizens’ perceptions about which technologies and services should be prioritized to be publicly funded?

Methods A sequential mixed-methods study. In the qualitative case study, we collected information through semi-structured interviews with 46 citizens belonging to five groups (i.e., plain citizens, patients, health workers, healthcare managers, and health policymakers). Interviews were audio-recorded and transcribed, with thematic analysis conducted of all transcripts.

Results Eight themes explain the citizens’ rationale to prioritize health technologies or services that the Colombian health system should publicly fund. Those were: 1) coverage depends on the socio-economic conditions of the person; 2) prioritize technologies supported by evidence of efficacy; 3) coverage should depend on the patient‘s necessity and prescription of the doctor; 4) technologies or services that improve quality of life should be publicly funded; 5) coverage depends on the vulnerability of the person; 6) instead of general rules about inclusion/exclusion, each case need to be analyzed; 7) all technologies and services should be covered because is better spend the money in patients needs than in corruption, and 8) all technologies and services should be covered and the health systems should not consider any exclusion.

Conclusion We identified that citizens’ rationales to prioritize technologies to be publicly funded depend on the patient‘s characteristics, type of disease, type of technology, and features of the health system. Those arguments and rationales for prioritization are coupled and founded on discussions about social justice from egalitarian, utilitarian and Rawlsian approaches.