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Bill

A 5393

Reduces copayments and coinsurance for asthma inhalers covered by certain health benefits plans.

2024-2025 Regular Session Introduced by Mike Venezia

New Jersey bill eliminates copayments and coinsurance for asthma inhalers under certain insurance plans to reduce out-of-pocket medication costs.

Introduced in the Assembly, Referred to Assembly Financial Institutions and Insurance Committee
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Bill Summary · A 5393

Legislative bill overview

Assembly Bill A 5393 would require health insurance plans in New Jersey to reduce or eliminate copayments and coinsurance costs for asthma inhalers. The bill targets medications covered under certain health benefits plans, aiming to improve patient access to these essential respiratory medications by lowering out-of-pocket expenses at the point of sale.

Why is this important

Asthma affects approximately 7% of New Jersey residents and is a leading cause of emergency department visits and hospitalizations. High copayments can discourage patients from obtaining prescribed inhalers, leading to worse health outcomes, more severe asthma attacks, and increased emergency care costs. Reducing cost barriers could improve medication adherence and overall public health outcomes for asthma sufferers.

Potential points of contention

  • Insurance premium increases: Insurers may argue that eliminating copayments will increase overall plan costs, potentially raising premiums for all enrollees rather than just benefiting asthma patients
  • Coverage scope ambiguity: The bill's reference to "certain health benefits plans" may create inconsistent coverage across different insurance types and employers, leaving some patients uncovered
  • Fiscal impact on state programs: If the bill applies to state-administered plans (Medicaid, public employee insurance), it could increase government healthcare expenditures without identified funding mechanisms

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

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