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HCR 42

Expresses support for TrumpRx and encourages actions to prevent discriminatory insurance practices

2026 Regular Session Introduced by Chad Perkins

Missouri urges action to lower drug costs by applying patient payments to deductibles and out-of-pocket maxes across direct-purchase and traditional channels, including MO HealthNe

Public Hearing Completed (H)
#drugsandcontrolledsubstances #federal-staterelations #generalassembly
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Bill Summary · HCR 42

Summary of Bill: HCR 42 (Missouri, 2026)

Overview

  • Type: House Concurrent Resolution (HCR)
  • Session: 2026, 103rd General Assembly
  • Introduced by: Representative Perkins (Co-sponsor: Chad Perkins)
  • Status: Referred to Health and Mental Health (H) committee on 2026-04-15

Purpose and Intent

HCR 42 expresses formal support for the TrumpRx initiative and urges action by federal and state actors to promote affordable prescription drugs while protecting patient access to health plan benefits. The resolution also seeks to ensure that patient-paid drug costs, including those obtained via TrumpRx and similar direct-purchasing platforms, are applied toward patient cost-sharing requirements (e.g., deductibles and out-of-pocket maximums). Additionally, it asks state agencies to explore and remove barriers to MO HealthNet (Missouri’s Medicaid program) participation in related federal efforts to lower drug costs.

Key Provisions

  • Support for TrumpRx: The resolution explicitly expresses support for TrumpRx, an online direct-purchasing platform announced by the Trump Administration intended to connect American patients with lower-priced prescription medications and increase price transparency.

  • Protection of Health Plan Benefits: It urges federal action to prevent discriminatory insurance practices and requires health plans and pharmacy benefits managers (PBMs) to apply patient-paid prescription drug expenditures toward cost-sharing obligations (deductibles and out-of-pocket maximums), including items purchased via TrumpRx and similar platforms.

  • Application of Patient Payments: The resolution calls for insurers and PBMs to commit to applying all patient-paid drug costs toward out-of-pocket requirements, regardless of whether the drugs are obtained through traditional channels or direct-purchasing platforms.

  • MO HealthNet/GGENEROS Model Engagement: It references the Centers for Medicare & Medicaid Services’ GENEROUS Model (GENERating cost Reductions for U.S. Medicaid), announced November 6, 2025, which allows state Medicaid programs to voluntarily access lower drug prices through federally negotiated supplemental rebates. The resolution asks the Missouri Department of Health and Senior Services to assess this GENEROUS Model and report on barriers or delays to MO HealthNet participation, with the goal of realizing potential cost savings for Missouri.

  • Messaging and Outreach: The resolution directs the Chief Clerk to prepare inscribed copies for the President, the U.S. Secretary of Health and Human Services, and members of Missouri’s congressional delegation, signaling formal, ceremonial support and communication.

Who Is Affected

  • Missouri Patients: Potentially benefit from lower drug costs and preserved access to existing health plan benefits via alignment of patient payments with cost-sharing requirements.
  • Insurers and PBMs in Missouri: Encouraged to apply patient-paid drug expenditures toward deductibles and out-of-pocket maximums.
  • MO HealthNet (Missouri Medicaid): Targeted for assessment and potential participation in GENEROUS Model to achieve federal rebate-driven savings.
  • Federal Partners: Specifically the U.S. Department of Health and Human Services and policymakers involved in TrumpRx initiatives and GENEROUS Model.

Procedural and Timeline Aspects

  • Legislative Path: The measure is a concurrent resolution, meaning it expresses the sentiment of both chambers but does not by itself create law or binding policy; it signals priorities and requests action from federal and state agencies.
  • Timeline References: Mentions actions and announcements occurring in 2025 (TrumpRx announcement on Sept. 30, 2025; GENEROUS Model announced Nov. 6, 2025) to frame the policy context and opportunities.
  • Next Steps Requested: The Missouri Department of Health and Senior Services should assess the GENEROUS Model and report on barriers to MO HealthNet participation.

Notes on Impact

  • The resolution emphasizes aligning patient financial responsibility with actual drug purchases across both traditional and direct-purchasing channels.
  • It aims to promote market competition and affordability without compromising existing health plan coverage.
  • As a non-binding measure, it reflects state legislative interest and advocacy for federal action, as well as state-level exploration of Medicaid cost-saving mechanisms.

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

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