Relating to insurance coverage for prescription insulin drugs

Topics:Health care Insurance Prescription drug prices

Official bill page Lobbyist declarations One-pager to print

Where it is now

Done: IntroducedJanuary 27, 2020
Done: SubcommitteeFebruary 5, 2020
Done: Senate committeeJune 5, 2020
Stopped: Passes the SenateDied when the General Assembly ended
Skipped: House committeeSkipped
Done: Passes the HouseMarch 9, 202098–1
Next: To the Governor
Next: Signed into law

Died when the session ended The 2020 session adjourned on June 14, 2020, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?

What’s in it

AI summary Health insurance plans in Iowa would have to limit how much people pay for a 30-day supply of prescription insulin. No matter the type of insulin, a person's out-of-pocket costs like copays or deductibles cannot be more than $100. This rule applies to most insurance plans but does not include certain specialized health insurance.¹

Read the official explanation

This bill relates to prescription insulin drugs and coverage by policies, contracts, or plans providing for third-party payment or prepayment of health or medical expenses that provide coverage for prescription drugs. The bill requires a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses that provides coverage for prescription drugs to cap the total amount of cost-sharing that a covered person is required to pay for a prescription insulin drug to an amount not more than $100 for a 30-day supply, regardless of the amount or type of prescription insulin drug required to fill the covered person’s prescription. “Prescription insulin drug” is defined in the bill as a prescription drug that contains insulin, is used to treat diabetes, and that has been prescribed as medically necessary by a covered person’s health care professional. The bill defines “cost-sharing” as any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense imposed on a covered person. The bill does not prohibit a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses from reducing a covered person’s cost-sharing to less than $100 for a 30-day supply of a prescription insulin drug. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2021, by the third-party payment providers enumerated in the bill. The bill specifies the types of specialized health-related insurance which are not subject to the coverage requirements of the bill. The commissioner of insurance is required to adopt rules to administer the requirements of the bill.

Changed since by amendment H-8016; see Amendments.

Full bill text²

Senate subcommittee

Named February 5, 2020. Meeting: Monday, February 17 · 4:00 PM · RM 315.

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Iowa Code it changes

Creates§514C.18A

How the Code works³

Lobbying

11 for · 0 against · 26 undecided · Who →

Family tree

Study bill

HSB 501Cleared committee

88th General Assembly

HF 2138Passed a chamberHouse companion SF 2113Cleared committeeSenate companion

Picked up later

HF 263Passed a chamber89th GA HF 502Cleared committee90th GA HF 694Cleared committee90th GA

Earlier and later bills are matched by wording or an identical title.

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