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Bill

HB 3057

Relating to health benefit plan coverage for chimeric antigen receptor T-cell therapy.

89th Legislature (2025) Introduced by Adam Hinojosa and 2 co-sponsors

Texas mandates health insurance coverage of CAR-T cell cancer therapy without prior authorization delays, ensuring patient access to expensive immunotherapy starting September 2025.

Effective on 9/1/25
#cancer(s0658) #health&humanservicescommission(v0177) #health--children'sinsurance(i0388) #health--otherdiseases&medicalconditions(i0383) #insurance #commissionerof(v0396) #insurance--health&accident(i0422) #medicaid(s4885)
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Bill Summary · HB 3057

Legislative bill overview

HB 3057 requires health benefit plans in Texas to cover chimeric antigen receptor T-cell (CAR-T) therapy, an advanced cancer treatment that genetically modifies a patient's own immune cells. The bill mandates coverage without prior authorization delays and limits out-of-pocket costs for this therapeutic approach. It became effective September 1, 2025, after being signed by the Governor in June.

Why is this important

CAR-T therapy is a cutting-edge treatment for certain blood cancers and lymphomas with high success rates, but costs between $373,000-$475,000 per patient, making insurance coverage critical for access. Without this mandate, many Texans would be unable to afford this life-saving treatment or face coverage denials from insurers seeking to limit expensive experimental therapies. The bill directly impacts healthcare equity by ensuring eligible patients have access regardless of financial status.

Potential points of contention

  • Cost burden on insurers and premiums: Health plans may pass treatment costs to employers and individual policyholders through higher premiums, potentially affecting affordability for other coverage
  • Prior authorization restrictions: Limiting pre-treatment approval requirements could reduce insurers' ability to verify medical necessity or explore alternative treatments first
  • Definition and scope ambiguity: Unclear whether the mandate covers all CAR-T variations, experimental applications, or only FDA-approved uses, potentially creating coverage disputes

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

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