HB625
Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.
Status:
Passed
Latest Action:
March 31, 2026
Governor's Action Deadline 11:59 p.m., April 13, 2026
Chief Patron:
Rozia Henson (D)
Session:
2026 Regular Session
Summary
As Passed House of Origin. 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 ... (More) 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, 2028. The provisions of the bill do not become effective unless reenacted by the 2027 Session of the General Assembly. (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) (15-Y 7-N)
- 02/09/2026 - House: Read first time
- 02/10/2026 - House: Read second time
- 02/10/2026 - House: committee amendment agreed to
- 02/10/2026 - House: Engrossed by House as amended
- 02/11/2026 - House: Read third time and passed House (63-Y 35-N 0-A) Close Floor Vote
- 02/12/2026 - Senate: Constitutional reading dispensed (on 1st reading)
- 02/12/2026 - Senate: Referred to Committee on Commerce and Labor
- 02/23/2026 - Senate: Reported from Commerce and Labor with substitute (11-Y 4-N)
- 02/24/2026 - Senate: Committee substitute printed 26108395D-S1
- 02/25/2026 - Senate: Rules suspended
- 02/25/2026 - Senate: Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
- 02/25/2026 - Senate: Passed by for the day Block Vote (Voice Vote)
- 02/26/2026 - Senate: Read third time
- 02/26/2026 - Senate: Commerce and Labor Substitute agreed to
- 02/26/2026 - Senate: Engrossed by Senate - committee substitute
- 02/26/2026 - Senate: Passed Senate with substitute (37-Y 3-N 0-A)
- 03/02/2026 - House: Senate substitute rejected by House (2-Y 97-N 0-A)
- 03/04/2026 - House: Fiscal Impact Statement from State Corporation Commission (HB625)
- 03/04/2026 - Senate: Senate insisted on amendment (40-Y 0-N 0-A)
- 03/04/2026 - Senate: Senate requested conference committee
- 03/05/2026 - House: House acceded to request
- 03/06/2026 - Senate: Conferees appointed by Senate
- 03/06/2026 - Senate: Senate Conferees: Perry, Rouse, Stanley
- 03/09/2026 - House: Conferees appointed by House
- 03/09/2026 - House: House Conferees: Henson, Ward, McLaughlin
- 03/10/2026 - House: Conference substitute printed 26109295D-H1
- 03/10/2026 - Conference Report released
- 03/10/2026 - House: Conference report agreed to by House (63-Y 33-N 0-A) Close Floor Vote
- 03/11/2026 - Senate: Conference report agreed to by Senate (39-Y 0-N 0-A)
- 03/30/2026 - House: Enrolled
- 03/30/2026 - House: Bill text as passed House and Senate (HB625ER)
- 03/30/2026 - Senate: Signed by President
- 03/31/2026 - House: Signed by Speaker
- 03/31/2026 - House: Enrolled Bill communicated to Governor on March 31, 2026
- 03/31/2026 - Governor's Action Deadline 11:59 p.m., April 13, 2026
