SPONSOR: Wright
COMMITTEE ACTION: Voted "Do Pass" by the Standing Committee on Health and Mental Health Policy by a vote of 9 to 2. Voted "Do Pass" by the Standing Committee on Rules- Administrative Oversight by a vote of 7 to 0.
This bill provides that when calculating an enrollee's overall contribution to an out-of-pocket maximum or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager must include any amounts paid by the enrollee or paid on behalf of the enrollee only for medication where a generic substitute is not available.
This bill is similar to HCS HB 442 (2023).
PROPONENTS: Supporters say that this bill will allow patients to get assistance with paying for their prescriptions; many spoke to their need for expensive prescriptions to treat complex medical issues that do not have cheaper generic alternatives available, and the value to patients does not change even though the price of the drug may change. Additionally, adherence to medication is critical for sustained treatment plans for complex medical issues, and affordability can be a major barrier.
Testifying in person for the bill were Representative Wright; Melissa, Arthritis Foundation; Megan Larsen; Missouri Association of Osteopathic Physicians and Surgeons; ALS Association; Missouri State Medical Society; Sarah Jamison; Anna Meyer, National Multiple Sclerosis Society; American Cancer Society-Cancer Action Network; Wayne Lee; Missouri Pharmacy Association; Bridget Tyrey, Gateway Hemophilia Association; Mark S. Box, MD; and Jackie Glasscock.
OPPONENTS: Those who oppose the bill say that because manufacturers set drug prices, this legislation does nothing to address the cost of drugs, and that costs for consumers will rise in increased insurance premiums and decreased access to services.
Testifying in person against the bill were Missouri Insurance Coalition; Louise Probst, St. Louis Area Business Health Coalition; America's Health Insurance Plans; Blue Cross Blue Shield of KC; and Mark Dalton.
OTHERS: Others testifying on the bill say that many drugs that are intended to treat complex medical issues, such as cancer, do not have generic alternatives for patients. Testifying in person on the bill was Leigh Anne Haun, Missouri Developmental Disabilities Council.
Written testimony has been submitted for this bill. The full written testimony and witnesses testifying online can be found under Testimony on the bill page on the House website.
Statutes affected: