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HB 3450

Creates provisions relating to insurance coverage of preventive health care services

2026 Regular Session Introduced by Pattie Mansur

Missouri health plans must cover USPSTF/ACIP/HRSA preventive services without cost-sharing starting Jan 1, 2026, with an advisory panel updating covered services.

Referred: Emerging Issues(H)
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Bill Summary · HB 3450

Summary of HB 3450 (2026) – Missouri

Purpose and intent

  • Establishes that health benefit plans issued or renewed in Missouri on or after January 1, 2026 must provide preventive health care services without cost-sharing, in alignment with specified federal guidelines and recommendations.
  • Creates a dedicated advisory committee to review and recommend updates to the list of preventive services.

Key provisions

  1. Scope of coverage without cost-sharing

    • Health carriers/health benefit plans must cover, with no cost-sharing, the following for the individual:
      • Evidence-based items or services with an A or B rating from the U.S. Preventive Services Task Force (USPSTF).
      • Immunizations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP).
      • Preventive care and screening outlined in comprehensive guidelines supported by the federal Health Resources and Services Administration (HRSA).

  2. Out-of-network considerations

    • If a plan uses a network, cost-sharing can be applied to the covered preventive services if delivered by an out-of-network provider, to the extent permissible under law.

  3. High deductible health plans (HDHPs)

    • For insureds enrolled in an HDHP, the plan may apply the HDHP deductible to the preventive coverage described above, unless the coverage is within a “safe harbor” under 26 U.S.C. § 223(c)(2)(C).

  4. Additional coverage allowed

    • The bill does not prevent plans from covering services beyond USPSTF/ACIP/HRSA recommendations, nor from denying coverage for non-recommended services.

  5. Enforcement and guidelines

    • The Missouri Director of the Department of Commerce and Insurance must enforce these provisions in line with:
      • USPSTF, ACIP, HRSA guidelines in effect as of December 31, 2025, and related federal rules/guidance.
    • The director will also adopt rules requiring coverage without cost-sharing for any preventive service recommendations/guidelines issued after December 31, 2025, by USPSTF, ACIP, or HRSA.

  6. Advisory Committee

    • Establishes the “Health Insurance Preventive Health Care Services Advisory Committee” within the Department.
    • Composition: 5 members (3 health care providers, 2 health carriers/health benefit plans).
    • Appointed by the director; members serve at the director’s pleasure and without compensation.
    • Responsibilities: meet at least annually to recommend updates or modifications to the covered preventive services; must provide recommendations by November 1 each year to the Department, the General Assembly, and the Governor.

  7. Rulemaking and legal framework

    • Any rules issued under this authority must comply with Chapter 536 (which governs Missouri rulemaking).
    • Nonseverability: if current constitutional provisions about legislative review of rules are struck down, rulemaking authority and subsequent rules after August 28, 2026, would be invalid.

Who is affected

  • Health benefit plans and health carriers operating in Missouri that issue or renew policies after January 1, 2026.
  • Insured individuals and enrollees in those plans, who would receive preventive services with no cost-sharing (subject to network considerations and HDHP deductible application).
  • State regulatory agency: Department of Commerce and Insurance, which would enforce the provisions and establish the advisory committee.

Timeline and procedural notes

  • Effective date for coverage requirements: January 1, 2026.
  • The Department will adopt implementing rules to ensure compliance, including rules about cost-sharing and safe harbor determinations for HDHPs.
  • Advisory Committee must meet annually and provide recommendations by November 1 of each year.
  • The bill references ongoing alignment with federal guidelines in effect through December 31, 2025, and anticipates updates for new federal guidance issued after that date.

Potential impact considerations

  • Could increase the number of preventive services covered without out-of-pocket costs for Missouri consumers, potentially improving preventive care uptake.
  • May influence insurance premium pricing due to expanded coverage, though the bill does not directly address premium impacts.
  • The HDHP deductible interaction could affect how plans structure cost-sharing for high-deductible plan enrollees.
  • Establishment of an advisory committee provides a mechanism for regular updates as federal guidance evolves.

Note: The bill text is consistent with similar measures (e.g., SB 1705, 2026) and reflects Missouri’s aim to align private health coverage with federal preventive care guidelines.

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

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