The bill amends RCW 48.43.780 to establish cost caps for prescription medications, specifically insulin, asthma inhalers, and epinephrine autoinjectors. For health plans issued or renewed on or after January 1, 2023, the total amount an enrollee must pay for covered insulin drugs is capped at $35 per 30-day supply, with coverage provided without a deductible. Starting January 1, 2025, similar provisions will apply to prescription asthma inhalers and epinephrine autoinjectors, which must also be capped at $35 per 30-day supply and covered without being subject to a deductible.

Additionally, the bill includes provisions for health plans offered as qualifying health plans for health savings accounts, requiring that cost-sharing for these medications be set at a minimum level to maintain the enrollee's ability to claim tax-exempt contributions. The Office of the Insurance Commissioner is tasked with notifying affected parties of any changes in IRS guidance regarding these prescription drugs. The bill also allows health plans to apply drug utilization management strategies to the medications covered under the new provisions, as long as it does not conflict with the established caps.

Statutes affected:
Original Bill: 48.43.780
Substitute Bill: 48.43.780
Bill as Passed Legislature: 48.43.780
Session Law: 48.43.780