Insurance: health insurers; cost-sharing for insulin coverage; eliminate. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406qq.

2025-2026 Regular Session Introduced by Darrin Camilleri and 2 co-sponsors

SB 1033 would reduce or eliminate cost-sharing for insulin in Mich. health insurance plans, limiting copays/coinsurance for insured insulin users.

SENATE CO-SPONSOR(S) NAMED: ERIKA GEISS

#health:pharmaceuticals #insurance:healthinsurers

Summary of SB 1033 (2025-2026, Michigan)

This summary outlines the main purpose, key provisions, affected parties, and procedural timelines for Senate Bill 1033 introduced in the 2025-2026 Michigan legislative session. The bill adds new statutory provision 3406qq to the Insurance article (1956 PA 218, MCL 500.100 - 500.8302).

Purpose and intent

The bill aims to address cost-sharing for insulin coverage by health insurers. While the exact text of section 3406qq is not provided in the summary, the title indicates that the measure seeks to eliminate certain cost-sharing requirements for insulin coverage under health insurance policies.

In broad terms, the bill aligns with reform efforts to reduce out-of-pocket insulin costs for insured individuals.

Key provisions (as implied by the title and typical structure of similar reforms)

Adds new statutory section: Sec. 3406qq to the Michigan Insurance Code (1956 PA 218).

Subject matter: Health insurers' cost-sharing for insulin coverage.

Expected changes may include:

Restrictions on copayments, coinsurance, or deductible requirements for insulin products.
Possible caps or prohibitions on certain insulin-related cost-sharing tiers within plans.
Requirements for insurers to apply standardized insulin coverage terms across plans.

The precise mechanisms (e.g., dollar caps, percentage caps, exemption criteria, or exemptions for specific insulin formulations) would be detailed in the enacted text of Sec. 3406qq.

Who would be affected

Health insurers regulated under Michigan’s Insurance Code (e.g., private health plans, commercial insurers, and possibly state-regulated plans).

Individuals who use insulin products and hold insured health coverage from a plan within Michigan.

Potential indirect effects on formulary design, plan pricing, and premium-setting if insurers adjust coverage terms in response to the new requirement.

Procedural and timeline considerations

Introduction: June 10, 2026.

Referral: Referred to the Senate Committee on Health Policy for consideration and potential hearings.

Sponsorship: Primary sponsor and co-sponsors listed:

Primary: Senator Chadrick Greene (as introduced)
Co-sponsors: Senator Darrin Camilleri; Senator Chedrick Greene; Senator Erika Geiss

Next steps in the legislative process typically include committee analysis, potential amendments, a committee vote, and eventual floor action in the Senate, followed by consideration in the House if passed.

Potential impacts and considerations

Consumer relief: If enacted as intended, the bill could reduce out-of-pocket costs for insulin for many insured individuals, improving affordability and adherence for those who rely on insulin.

Insurer compliance: Insurers would need to adjust policy terms and cost-sharing structures to comply with Sec. 3406qq, which could involve administrative changes and potential system updates.

Market effects: Depending on the specifics (caps or prohibitions), there could be downstream effects on premiums, plan design, and formulary management.

Legal and regulatory clarity: The new provision would require alignment with federal laws and existing state regulations governing health plan cost-sharing and insulin coverage.

Note: The precise operational details (e.g., exact dollar amounts, caps, exemptions) are defined in the enacted text of Sec. 3406qq. The summary above reflects the bill’s stated aim and likely areas of change based on the title and typical policy patterns for insulin cost-sharing reform.