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Bill Summary · HB 3368

Purpose and intent

HB 3368 seeks to create a state-supported program to pay for vasectomies for uninsured Missouri residents and to require health insurance plans sold in Missouri to cover vasectomies without medical-necessity or additional cost barriers. The overarching goals are to improve access to vasectomies for those without private or public insurance and to standardize coverage across health plans starting in 2027.

Key provisions

State-funded vasectomy assistance (uninsured residents)

  • Establishes a state assistance program within the Department of Social Services (DSS), contingent on appropriation.
  • Eligibility: Any Missouri resident who does not have employer-sponsored insurance or public health insurance coverage is eligible. Income or resources are not considered for eligibility.
  • Medical necessity: DSS may not require a finding of medical necessity or impose other eligibility restrictions beyond those stated.
  • Coverage and payment: DSS will pay providers for vasectomies on behalf of eligible individuals, based on a department-defined reasonable cost.
  • Administration and funding: Creates the Vasectomy Fund in the state treasury to hold appropriated funds and any gifts or grants. The fund is dedicated to vasectomy payments and related administrative costs. Unspent funds do not revert to general revenue and will earn interest.

Health insurance coverage requirement (private plans)

  • Starting January 1, 2027, every health carrier or health benefit plan delivered, issued, continued, or renewed in Missouri must cover vasectomies.
  • Medical necessity: No requirement for a medical-necessity finding to obtain coverage.
  • Cost sharing: Deductibles and co-payments for vasectomies must not be greater than those for other covered services under the plan.
  • Scope: Applies to most health plans but expressly excludes certain supplemental policies (e.g., life care contracts, accident-only policies, specified disease policies, certain Medicare supplement policies, long-term care, some short-term policies, and other supplemental policies as determined by the Commissioner of the Department of Commerce and Insurance).

Who is affected

  • Uninsured male residents of Missouri who lack employer-sponsored or public health insurance.
  • Medical providers performing vasectomies for eligible individuals.
  • Private health insurance issuers and plans offered in Missouri beginning in 2027.
  • Consumers purchasing or holding health plans that fall under the insured group, subject to the stated coverage and cost-sharing rules.

Procedural and timeline aspects

  • Effective date for insurance coverage mandate: January 1, 2027.
  • The program within DSS is subject to annual appropriation; benefits depend on funds available in the Vasectomy Fund.
  • The bill includes a regulatory framework to be established by DSS for implementing the uninsured program, with rules subject to existing Missouri rulemaking and administrative law processes.

Notes

  • The measure creates a dedicated funding mechanism (Vasectomy Fund) and specifies nonreversion of unused funds during the biennium.
  • The bill aligns with a broader policy aim to expand access to vasectomies, balancing public funding with private plan requirements.
  • Similar prior proposals exist (HB 1547, 2025).

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

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