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HB 516

Health insurance; coverage for non-opioid prescription drugs.

2026 Regular Session Introduced by Marty Martinez

Bill requires Virginia health insurers to cover non-opioid prescription drug alternatives to address opioid addiction, but faces cost concerns and insurer resistance.

Subcommittee recommends laying on the table (5-Y 4-N)
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Bill Summary · HB 516

Legislative bill overview

HB 516 would require health insurance plans in Virginia to provide coverage for non-opioid prescription drugs as alternatives to opioid pain medications. The bill aims to expand access to pharmaceutical options that may reduce opioid dependence while giving patients and doctors more treatment flexibility.

Why is this important

Opioid addiction and overdose deaths remain a significant public health crisis. Expanding insurance coverage for non-opioid alternatives could reduce inappropriate opioid prescribing, lower addiction rates, and decrease overdose mortality. However, the bill's fate appears uncertain given the subcommittee's recent "lay on the table" recommendation, which effectively pauses or kills the legislation.

Potential points of contention

  • Insurance cost implications: Mandating coverage for non-opioid drugs increases insurer costs, which may be passed to employers and consumers through higher premiums
  • Formulary autonomy: Insurance companies argue they should determine which drugs to cover based on clinical evidence and cost-effectiveness, not legislative mandate
  • Scope ambiguity: The bill's definition of "non-opioid prescription drugs" may be unclear—does it cover all alternatives or only specific proven substitutes?

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

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