VirginiaHealth insurance; limit on cost-sharing payments for prescription drugs under certain plans.
What it does
Health insurance; limit on cost-sharing payments for prescription drugs under certain plans. Requires each carrier that offers a health plan in either the individual or small group market to ensure that at least one health plan in each of the bronze, silver, gold, and platinum levels of coverage in each rating area in the individual and small group market conform with the following: (i) a plan that offers a platinum level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $150 per 30-day supply of the prescription drug; (ii) a plan that offers a gold level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $200 per 30-day supply of the prescription drug; (iii) a plan that offers a silver level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $250 per 30-day supply of the prescription drug; and (iv) a plan that offers a bronze level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $300 per 30-day supply of the prescription drug. The bill requires that any plans offered to meet its requirements are (a) clearly and appropriately named to aid the consumer or plan sponsor in the plan selection process and (b) marketed in the same manner as other plans offered by the carrier.
More detail
The bill's provisions apply to any individual or group accident and sickness insurance policy, any individual or group accident and sickness subscription contract, and any health care plan for health care services delivered, issued for delivery, or renewed in the Commonwealth on or after January 1, 2028. This bill is identical to HB 625.
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Apr 13Acts of Assembly Chapter text (CHAP0642)Latest
- Apr 13Approved by Governor Abigail Spanberger-Chapter 642 (effective 7/1/2026)Became Law
- Mar 31Governor's Action Deadline 11:59 p.m., April 13, 2026To Governor
- Mar 31Enrolled Bill communicated to Governor on March 31, 2026Minor
- Mar 31Signed by SpeakerMajor
- Mar 30Signed by PresidentMajor
- Mar 30Bill text as passed Senate and House (SB161ER)Major
- Mar 30EnrolledMinor
- Mar 10Conference report agreed to by House (63-Y 33-N 0-A)Minor
- Vote recorded Adopt Conference Committee Report R. Result: pass.Lower
- Mar 9Conference report agreed to by Senate (38-Y 2-N 0-A)Minor
- Vote recorded Adopt Conference Committee Report R. Result: pass.Upper
- Mar 6Conference Report released
- Mar 5House Conferees: Henson, Ward, McLaughlin
- Mar 5Conferees appointed by House
- Mar 3Fiscal Impact Statement from State Corporation Commission (SB161)
- Vote recorded Accede Conference Committee R. Result: pass.Upper
- Mar 3Senate Conferees: Perry, Rouse, Stanley
- Mar 3Conferees appointed by Senate
- Mar 3Senate acceded to request Block Vote (40-Y 0-N 0-A)
- Feb 27House requested conference committeeMinor
- Feb 27House insisted on substituteMajor
- Feb 26House substitute rejected by Senate (0-Y 40-N 0-A)
- Vote recorded Concur House Substitute R. Result: fail.Upper
- Feb 24Passed House with substitute (64-Y 34-N 0-A)Passed House
- Vote recorded H VOTE:. Result: pass.Lower
- Feb 24Engrossed by House - committee substituteMajor
- Feb 24committee substitute agreed toMajor
- Feb 24Read third timeMinor
- Feb 23Read second timeMinor
- Feb 19Committee substitute printed 26108163D-H1Major
- Vote recorded Reported from Labor and Commerce with substitute. Result: pass.Lower
- Feb 19Reported from Labor and Commerce with substitute (14-Y 6-N)Minor
- Feb 12Referred to Committee on Labor and CommerceMinor
- Feb 12Read first timeMinor
- Feb 12Placed on Calendar
- Feb 6Read third time and passed Senate (34-Y 6-N 0-A)Passed Senate
- Vote recorded Passage R. Result: pass.Upper
- Feb 5Engrossed by Senate as amended (Voice Vote)
- Feb 5Commerce and Labor Amendment agreed toMajor
- Feb 5Read second timeMinor
- Feb 4Passed by for the day Block Vote (Voice Vote)
- Vote recorded Constitutional reading dispensed R. Result: pass.Upper
- Feb 4Constitutional reading dispensed Block Vote (on 1st reading) (40-Y 0-N 0-A)
- Feb 4Rules suspended
- Feb 2Reported from Commerce and Labor with amendment (9-Y 4-N)Minor
- Vote recorded Reported from Commerce and Labor with amendment. Result: pass.Upper
- Jan 26Senate committee offered
- Jan 25Fiscal Impact Statement from State Corporation Commission (SB161)
- Jan 7Referred to Committee on Commerce and LaborMinor
- Jan 7Prefiled and ordered printed; Offered 01-14-2026 26101280DIntroduced