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HB625

Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

Status:
In House

Latest Action: Feb. 5, 2026
House: Reported from Labor and Commerce with amendment(s)

Chief Patron:
Rozia Henson (D)

Session:
2026 Regular Session

Summary

As Introduced. Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

Requires each carrier that offers a health plan in either the individual or small group market to ensure that at least 50 percent of all health plans offered by the carrier, or at least one health plan if the carrier offers fewer than two health plans, in each rating area and in each of the bronze, silver, gold, and platinum levels of coverage in the individual and small group market conform with the following: (i) a plan that offers a silver, gold, or platinum level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $100 per 30-day supply of the prescription drug and (ii) a plan that offers a bronze level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $150 per 30-day supply of the prescription drug. The bill provides that such limits apply at any point in the benefit design, including before and after any applicable deductible is reached. The bill requires that any plans offered to meet its requirements are (a) clearly and appropriately named to aid the consumer or plan sponsor in the plan selection process and (b) marketed in the same manner as other plans offered by the health insurance carrier. The provisions of the bill apply with respect to health plans entered into, amended, extended, or renewed on or after January 1, 2027. (Less)
  • Bill History

  • 01/13/2026 - House: Prefiled and ordered printed; Offered 01-14-2026 26101225D
  • 01/13/2026 - House: Referred to Committee on Labor and Commerce
  • 01/20/2026 - House: Assigned HCL sub: Subcommittee #1
  • 01/30/2026 - House: Placed on Labor and Commerce Agenda
  • 02/03/2026 - House: Subcommittee failed to recommend reporting (4-Y 5-N)
  • 02/03/2026 - House: Reconsidered by Labor and Commerce (Voice Vote)
  • 02/03/2026 - House: Subcommittee recommends reporting with amendment(s) (6-Y 3-N)
  • 02/04/2026 - House: Placed on Labor and Commerce Agenda
  • 02/05/2026 - House: Reported from Labor and Commerce with amendment(s)