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SB 5729

Extending the expiration date on the cost-sharing cap for insulin.

2023-2024 Regular Session Introduced by Annette Cleveland and 9 co-sponsors

Permanently caps insulin cost-sharing at $35 per 30-day supply in Washington health plans, removing the sunset; insulin is covered without a deductible.

Effective date 7/23/2023.
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Bill Summary · SB 5729

Summary — SB 5729 (insulin cost‑sharing cap)

Status: Enacted (chaptered), effective July 23, 2023
Primary subject: Removing the expiration date on the $35 insulin cost‑sharing cap (amendment to RCW 48.43.780)

Purpose / intent

Make permanent a statutory cap on patient out‑of‑pocket cost sharing for prescription insulin in Washington state. The policy aims to preserve affordable access to life‑saving insulin for people with diabetes by codifying the $35 per 30‑day supply cap introduced by prior temporary laws.

Key provisions

  • Removes the statute’s previous sunset/expiration date so the $35 cost‑sharing cap is ongoing rather than temporary.
  • Requires health plans issued or renewed on or after January 1, 2023 that cover prescription insulin to cap an enrollee’s total cost sharing at no more than $35 per 30‑day supply of insulin.
  • Prescription insulin must be covered without being subject to a deductible.
  • Any out‑of‑pocket costs an enrollee pays for insulin must be applied toward the enrollee’s deductible.
  • Exception for HSA‑qualified plans: if the IRS changes rules such that insulin is no longer a preventive service for HSA‑qualified plans (i.e., would affect pre‑deductible coverage for HSAs), the carrier may set cost sharing at the minimum level needed to preserve HSA tax treatment. The Office of the Insurance Commissioner must notify affected parties if this IRS guidance changes.
  • No appropriation included in the bill; a fiscal note was prepared.

Who is affected

  • Enrollees in Washington health plans (commercial and other regulated plans subject to RCW 48.43.780) that provide coverage for prescription insulin.
  • Health insurers / carriers offering such plans in Washington must comply with the cap and coverage rules.
  • The statute’s applicability to self‑insured ERISA plans is limited by federal law (such plans are typically not governed by state insurance mandates).

Timeline & procedural notes

  • Built on prior actions: 2020 law capped insulin at $100 (through Jan 1, 2023); 2022 law reduced the cap to $35 and set an expiration (initially Jan 1, 2024). SB 5729 removed that expiration.
  • Legislative action (2023): Passed both chambers March 2023; Governor signed March 30, 2023. Official effective date: July 23, 2023.
  • No recorded organized opposition in committee testimony; supporters included diabetes advocacy groups.

Note: The Senate bill number SB 5729 has been used in multiple sessions for different measures. A separate SB 5729 introduced in 2025 pertains to streamlining permitting for affordable housing; this summary covers the 2023 insulin cost‑sharing law (RCW 48.43.780 amendment).

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

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