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HB 920

INSURANCE/HEALTH: Requires drug manufacturers to limit pricing of GLP-1 medications for health insurance plans (OR INCREASE GF EX See Note)

2026 Regular Session Introduced by Edmond Jordan

Cap patient cost-sharing for GLP-1 meds at $200 per 30-day supply and extend Medicaid/OGB coverage to GLP-1 drugs regardless of diagnosis.

Read by title, under the rules, referred to the Committee on Insurance.
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Bill Summary · HB 920

Legislative Bill Summary — HB 920 (Louisiana, 2026 Regular Session)

Title

INSURANCE/HEALTH: Requires drug manufacturers to limit pricing of GLP-1 medications for health insurance plans (increase GF EX See Note)

Primary purpose

To cap patient cost-sharing for GLP-1 medications on health insurance plans and to expand GLP-1 medication coverage to additional public and private programs, including Louisiana Medicaid and the Office of Group Benefits (OGB), regardless of the enrollee’s specific medical condition or diagnosis.

Key provisions

1) GLP-1 pricing limits for health insurance plans (new R.S. 22:1034.2)

  • Definitions:
    • Clarifies terms like “drug formulary,” “enrollee/insured,” “GLP-1,” and “health coverage plan.”
  • Cost-sharing cap:
    • A health coverage plan may not charge an insured more than $200 for a 30-day supply of GLP-1 medications, regardless of the specific GLP-1 drug or formulation prescribed.
    • Applies to any health coverage plan for which a provider issues a prescription, independent of the insured’s medical condition or diagnosis.
  • Scope: Applies across all health coverage plans subject to state law (including private plans and potentially public plans, as defined by the statute).

2) Medicaid coverage for GLP-1 medications (new Part IX of Chapter 5-E, title 40)

  • Medicaid expansion:
    • Louisiana Medicaid must make GLP-1 medications available to all eligible beneficiaries under Title XIX of the Social Security Act when a provider prescribes them.
    • Coverage is extended regardless of the enrollee’s specific medical condition or diagnosis.
  • Federal/state flexibility:
    • The Louisiana Department of Health may seek federal waivers and state plan amendments as needed to implement these provisions.

Who is affected

  • Enrollees/insured individuals covered by health insurance plans in Louisiana (private insurers, employer-sponsored plans, and other health coverage plans) who use GLP-1 medications.
  • Louisiana Medicaid beneficiaries (and potentially related public programs) who are prescribed GLP-1 medications.
  • Health insurance issuers, insurers, and pharmacy benefit managers (PBMs) subject to the new cost-sharing cap.
  • The Louisiana Department of Health (DOH) for Medicaid implementation and potential federal waivers or amendments.

Timeline / procedural notes

  • Effective date and phased implementation details are not specified in the text provided. The bill adds:
    • New statute sections: R.S. 22:1034.2 and R.S. 40:1259.11.
  • Administrative path:
    • DOH may pursue Medicaid waivers and state plan amendments as necessary to implement GLP-1 coverage provisions.

Potential impacts

  • Consumers:
    • Predictable out-of-pocket costs for GLP-1 therapies capped at $200 for a 30-day supply, potentially increasing affordability and adherence.
  • Payers/insurers:
    • Providers of health coverage plans would need to adjust formularies and cost-sharing structures to comply with the $200 limit.
  • Public program beneficiaries:
    • Expanded GLP-1 access under Louisiana Medicaid, improving treatment options for eligible beneficiaries.
  • Policy considerations:
    • The bill’s impact on overall drug pricing, formulary management, and potential implications for other high-cost medications.

Additional notes

  • The bill includes a digest confirming its intent to cap GLP-1 cost-sharing and extend coverage across Medicaid, OGB, and other health plans.
  • Sponsors: Representative Edmond Jordan (and co-sponsor noted).
  • Status: Read by title and referred to the Committee on Insurance as of the provided action history.

This summary focuses on the substantive changes the bill would impose and who would be affected, helping readers quickly grasp the what, who, and how of HB 920.

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

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