SCS/SB 970 - This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available.

Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available.

The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.

This act is similar to HB 79 (2025) and substantially similar to provisions in SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022).

TAYLOR MIDDLETON

Statutes affected:
Introduced (5021S.01): 376.448
Committee (5021S.02): 376.448

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Senate Committee Minutes:
SENATE COMMITTEE MINUTES Bill No.: SB 970
Sponsor: Fitzwater
Hearing Date: 1/14/2026


COMMITTEE: Families, Seniors and Health

CHAIRMAN: Carter

DATE REFERRED: 1/8/2026 DATE HEARING REQUESTED: 1/8/2026



STAFF:
Sarah Haskins
Heidi Osner
Dennis Rhodes
Blake Thompson


WITNESSES GIVING INFORMATION:



WITNESSES FOR:
Jamie Thomas - M.S. Society
Gabrielle Flores
Bridget Tyrey
Emily Kalmer - American Cancer Society
Rachel Bauer - MSMA, MAOPS, MO State Osteopathic Assoc.
Angela Brown - Midwest Hemophilia Assoc.
Will Marrs - Mercy Health Systems
Arnie Deinhoff
Jessica Petrie - Reach Foundation
Henrio Thelemaque - Missouri Bootheel Regional Consortium
David Winton - Novartis & Pfizer
Tyler Travers - National Alliance on Mental Illness
Megan Howerton - Mosaic Life Care
Julie Carel


WITNESSES AGAINST:
Hampton Williams - Missouri Insurance Coalition
Mark Dalton - Mid-America Carpenters Regional Council
Shannon Cooper - America's Health Insurance Plans