Bills › 91st General Assembly
Relating to insurance coverage for prescription drugs used in the treatment of metastatic cancer and associated conditions
Sponsored by Sen. Annette Sweeney (R)
Topics:Health careInsurance
Where it is now
- Done: IntroducedFebruary 4, 2025
- Done: SubcommitteeFebruary 5, 2025
- Stopped: Senate committeeDied when the General Assembly ended
- Next: Passes the Senate
- Next: House committeeFunnel: by March 20, 2026
- Next: Passes the House
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2026 session adjourned on May 3, 2026, 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 will be required to cover certain prescription drugs used to treat metastatic cancer. These plans cannot use "step therapy," which is a rule that forces patients to try cheaper drugs before using a specific one. This change applies to most health insurance providers starting in 2026.1
Read the official explanation
This bill relates to insurance coverage for prescription drugs used in the treatment of metastatic cancer. The bill requires policies, contracts, or plans providing for third-party payment or prepayment of health or medical expenses that provide coverage for prescription drugs to provide coverage for prescription cancer drugs. “Prescription cancer drug” is defined in the bill as a prescription drug that is used to treat metastatic cancer or associated conditions. “Metastatic cancer” is also defined in the bill. The policy, contract, or plan is required to provide coverage, without imposing a step therapy protocol, for a prescription cancer drug that has been approved by the United States food and drug administration, the use of which is in accordance with medical standards of care for metastatic cancer and associated conditions, and the use of which is supported by peer-reviewed, evidence-based literature. “Associated conditions” is defined in the bill. “Step therapy protocol” is defined in the bill as a protocol or program that establishes a specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular covered person are covered under a pharmacy or medical benefit by a health carrier, a health benefit plan, or a utilization review organization, including self-administered drugs and drugs administered by a health care professional. The bill applies to 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 may adopt rules to administer the requirements of the bill. The provisions of the bill are applicable to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2026.
Senate subcommittee
Named February 5, 2025. On February 11, 2025 it recommended passage.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Family tree
Tried before
91st General Assembly
Earlier and later bills are matched by wording or an identical title.
Tried before
This idea has been filed in 3 earlier General Assemblies. None got through a chamber.
- HF 57 Relating to insurance coverage for prescription drugs used in the treatment of metastatic …90th General Assembly · In committee · same titleCleared committee
- SF 116 Relating to insurance coverage for prescription drugs used in the treatment of metastatic …89th General Assembly · In committee · nearly identicalCleared committee
- SF 2165 Relating to insurance coverage for prescription drugs used in the treatment of metastatic …89th General Assembly · In committee · nearly identicalCleared committee
- HF 873 Relating to insurance coverage for prescription drugs used in the treatment of stage IV ca…89th General Assembly · In committee · similarCleared committee
- SSB 3161 SSB 316188th General Assembly · Renumbered as SF 2384 · very similarCleared committee
Matched by wording or an identical title.