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Bill

HF 658

A bill for an act relating to insurance coverage for prescription insulin drugs.

2025-2026 Regular Session Introduced by Jerome Amos and 15 co-sponsors

Bill HF 658 caps out-of-pocket costs for insulin, ensuring individuals with diabetes can access medication affordably while requiring insurers to adjust their policies.

Introduced, referred to Commerce.
#insulin #insurance #prescriptiondrugs
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Bill Summary · HF 658

Summary of Bill HF 658: Insurance Coverage for Prescription Insulin Drugs

Purpose and Intent

Bill HF 658 aims to address the rising costs of prescription insulin drugs by mandating insurance coverage policies to limit the out-of-pocket expenses for individuals requiring insulin. The bill seeks to ensure that those with diabetes can access necessary medication without facing prohibitive cost-sharing obligations.

Key Provisions

  • Cost-Sharing Cap: The bill requires that any insurance policy, contract, or plan providing coverage for prescription drugs must cap the total amount of cost-sharing that a covered person is responsible for when obtaining insulin.

  • Applicable Insurance Types: The provisions of this bill apply to various classes of third-party payment provider contracts, including:

    1. Individual or group accident and sickness insurance.
    2. Individual or group hospital or medical service contracts.
    3. Individual or group health maintenance organization contracts.
    4. Plans established for public employees.

  • Exemptions: The bill specifies that it does not apply to certain types of insurance, including:

    • Accident-only insurance
    • Specified disease insurance
    • Short-term hospital or medical insurance
    • Dental and vision insurance
    • Medicare supplement insurance
    • Long-term care insurance
    • Workers’ compensation insurance

  • Regulatory Authority: The Commissioner of Insurance is authorized to adopt rules to administer the provisions of this bill, ensuring compliance and effective implementation.

Affected Parties

  • Individuals with Diabetes: The primary beneficiaries of this bill will be individuals who require insulin, as it aims to reduce their financial burden related to medication costs.

  • Insurance Providers: Insurance companies and health plans will need to adjust their policies and contracts to comply with the new cost-sharing limits.

Procedural Aspects

  • Introduced Date: The bill was introduced on February 28, 2025.
  • Current Status: As of now, the bill has been referred to the Commerce Committee for further consideration.

Conclusion

HF 658 represents a significant step towards making insulin more affordable for those who need it. By capping cost-sharing obligations, the bill aims to alleviate financial stress for individuals managing diabetes, while also imposing new requirements on insurance providers to ensure compliance with these provisions.

Compiled from official sources — confirm details with the bill’s official record.

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