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HB 32

AN ACT relating to coverage for epinephrine devices.

2026 Regular Session Introduced by Chad Aull and 14 co-sponsors

Kentucky health plans must cover at least two epinephrine devices per covered person annually with minimal out-of-pocket costs, starting Jan 1, 2027.

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Bill Summary · HB 32

Summary of HB 32 (2026RS) – Kentucky

Purpose and intent

HB 32 would require health benefit plans sold in Kentucky to cover epinephrine devices (single-use, premeasured epinephrine injections) for covered individuals, with limited cost sharing. The bill aims to improve access to life-saving epinephrine in cases of severe allergic reactions while limiting out-of-pocket costs.

Key provisions and changes

  • Section 1: Establishes a new section of Subtitle 17A of KRS Chapter 304.
    • Defines “cost sharing” (copays, coinsurance, deductibles, etc.) and “epinephrine device.”
    • Mandates coverage of at least two medically necessary epinephrine devices per covered person on an annual basis.
    • Prohibits cost sharing for this coverage up to $100 per year for most plans.
    • Includes a federal-federal-law exception: if applying the requirement would cause a plan to fail as a Health Savings Account-qualified High Deductible Health Plan (HDHP) under 26 U.S.C. § 223, the requirement won’t apply until the plan’s minimum deductible is satisfied.
  • Section 2: Amends KRS 304.17A-099 to address impact on qualified health plans and cost defrayal payments under federal law.
    • Provides a framework for calculating and collecting any costs defrayed by the state (statewide average costs, actuarial methods, reporting to the commissioner and Division of Health Benefit Exchange).
    • Establishes how such payments would be used to reduce premiums or provide rebates to individuals.
    • Creates a mechanism for penalties, funding via a dedicated trust, and regulatory authority for enforcement.
  • Section 3: Updates Medicaid-related provisions to align with the new epinephrine coverage framework.
  • Section 4: Updates KCHIP (Kentucky Children’s Health Insurance Program) requirements, including eligibility, benefits (vision, dental, preventive, etc.), copayment structure (no copays for KCHIP services), and bidding/contracting oversight to maximize competition.
  • Section 5–6: Other miscellaneous updates, including related Health Insurance provisions for state employees, postsecondary institutions, and eligibility rules for special enrollment periods (notably pregnant women).
  • Section 7: Effective date for Sections 1–6 is January 1, 2027.
  • Section 8–9: Federal waiver/authorization processes to ensure compliance with federal law and avoid loss of federal funds if required.
  • Section 10: Sections 3, 4, and 9 provide explicit authorization under KRS 205.5372(1).
  • Section 11: Sections 1–7 take effect January 1, 2027.

Who would be affected

  • All health benefit plans offered in Kentucky, including:
    • Fully insured and self-insured plans for state employees (KEHP) and their dependents.
    • Medicaid and CHIP programs (state plan alignment and administration).
    • Plans offered in the private market that fall under Kentucky’s jurisdiction.
  • Public employers and local governments offering health benefits to employees.
  • Beneficiaries and covered individuals, who would gain access to two epinephrine devices per person per year with limited out-of-pocket costs.

Procedural and timeline notes

  • Implementation target: January 1, 2027 (Sections 1–7).
  • Sec. 8–9 outline federal compliance steps, including potential waivers if necessary to preserve federal funding.
  • The bill provides regulatory authority to promulgate necessary rules and governs cost defrayment mechanics at the state level.

Fiscal notes (as provided)

  • Expected minimal to no net impact on local government budgets.
  • Epinephrine devices are relatively low-cost and under current plans are often covered; any premium impact is anticipated to be immaterial.
  • Potential cost savings could arise from reduced urgent-care or emergency claims due to wider epinephrine access.

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

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