The proposed bill requires that all group health coverage under the Health Care Purchasing Act provide comprehensive coverage for sexual, reproductive, and gender-affirming health care services without any cost-sharing or prior authorization. This includes preventive benefits, abortion care, pregnancy-related coverage, and gender-affirming care, ensuring these services are accessible without financial barriers. Additionally, the bill establishes a special enrollment period for uninsured individuals who are pregnant, allowing them to obtain coverage promptly. It also enhances contraception coverage by mandating plans to provide a sufficient quantity of contraceptives for continuous use and eliminating restrictions that could limit access.

Key amendments in the bill include the removal of previous limitations on contraceptive coverage, such as the requirement for a six-month supply, and the introduction of new definitions and protections for insured individuals. Insurers are prohibited from denying coverage based on medical necessity as determined by healthcare providers. The bill allows religious entities to opt out of covering prescription contraceptives while ensuring that the new regulations do not apply to high-deductible plans until deductibles are met. Overall, the legislation aims to improve access to essential health services and protect the rights of individuals seeking reproductive and gender-affirming care, with provisions taking effect for relevant policies starting January 1, 2027.

Statutes affected:
introduced version: 13-7-22, 27-2-12.29, 59A-22-42, 59A-23-7.14, 59A-46-44, 59A-47-45.5