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Bill

A 5354

Requires health insurers to provide coverage without cost-sharing for opioid antagonists and devices

2025 Regular Session Introduced by Phil Steck

Bill A 5354 mandates health insurers to cover opioid antagonists without cost-sharing, ensuring easier access to life-saving treatments for those at risk of overdose.

REFERRED TO INSURANCE
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WeVote Research Nonpartisan
Bill Summary · A 5354

Summary of Bill A 5354

Bill Information

  • Bill Number: A 5354
  • Title: Requires health insurers to provide coverage without cost-sharing for opioid antagonists and devices
  • Status: Referred to Insurance
  • Introduced: February 13, 2025
  • Classification: Bill

Purpose and Intent

Bill A 5354 aims to enhance access to opioid antagonists—medications that can reverse opioid overdoses—by mandating that health insurers cover these medications and associated devices without any cost-sharing for patients. The intent is to reduce barriers to obtaining life-saving treatments amid the ongoing opioid crisis.

Key Provisions

  • Coverage Requirement: The bill requires health insurance providers to cover opioid antagonists, such as naloxone, and any necessary devices (e.g., auto-injectors or nasal sprays) without imposing any out-of-pocket costs on the insured individuals.
  • Cost-Sharing Elimination: This provision means that patients will not have to pay deductibles, copayments, or coinsurance when accessing these critical medications.
  • Scope of Coverage: The bill specifies that coverage must include both prescription and over-the-counter versions of opioid antagonists.

Impact

  • Affected Parties:
    • Patients: Individuals at risk of opioid overdose will benefit from easier access to life-saving medications without financial barriers.
    • Health Insurers: Insurance companies will need to adjust their policies and coverage plans to comply with the new requirements.
    • Healthcare Providers: Medical professionals will be encouraged to prescribe and distribute opioid antagonists more freely, knowing that patients will not face cost barriers.

Procedural Aspects

  • Legislative Status: As of February 13, 2025, the bill has been referred to the Insurance Committee for further consideration. The timeline for additional hearings or votes has not yet been established.

Conclusion

Bill A 5354 represents a significant step towards combating the opioid crisis by ensuring that individuals have access to opioid antagonists without the burden of cost-sharing. By removing financial barriers, the bill aims to save lives and promote public health. Further legislative actions will determine the bill's progression and potential enactment.

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

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