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Health insurance; limit on cost-sharing payments for prescription drugs under certain plans. Requires each carrier that offers a health plan in either the individual or small group market to ensure that at least 50 percent of all health plans offered by the carrier, or at least one health plan if the carrier offers fewer than two health plans, in each rating area and in each of the bronze, silver, gold, and platinum levels of coverage in the individual and small group market conform with the following: (i) a plan that offers a silver, gold, or platinum level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $100 per 30-day supply of the prescription drug and (ii) a plan that offers a bronze level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $150 per 30-day supply of the prescription drug. The bill provides that such limits apply at any point in the benefit design, including before and after any applicable deductible is reached. The bill requires that any plans offered to meet its requirements are (a) clearly and appropriately named to aid the consumer or plan sponsor in the plan selection process and (b) marketed in the same manner as other plans offered by the health insurance carrier. The provisions of the bill apply with respect to health plans entered into, amended, extended, or renewed on or after January 1, 2028. The provisions of the bill do not become effective unless reenacted by the 2027 Session of the General Assembly.
Introduced
Jan 13, 2026
Last Action
Mar 11, 2026
Session
VA 2026
Sponsors
1 primary · 1 co
Conference report agreed to by Senate (39-Y 0-N 0-A)
Conference report agreed to by House (63-Y 33-N 0-A)
Conference Report released
House Conferees: Henson, Ward, McLaughlin
Conferees appointed by House
Conferees appointed by Senate
Senate Conferees: Perry, Rouse, Stanley
House acceded to request
Senate requested conference committee
Senate insisted on amendment (40-Y 0-N 0-A)
Fiscal Impact Statement from State Corporation Commission (HB625)
Senate substitute rejected by House (2-Y 97-N 0-A)
Commerce and Labor Substitute agreed to
Passed Senate with substitute (37-Y 3-N 0-A)
Engrossed by Senate - committee substitute
Read third time
Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
Rules suspended
Passed by for the day Block Vote (Voice Vote)
Committee substitute printed 26108395D-S1
Reported from Commerce and Labor with substitute (11-Y 4-N)
Referred to Committee on Commerce and Labor
Constitutional reading dispensed (on 1st reading)
Read third time and passed House (63-Y 35-N 0-A)
committee amendment agreed to
Engrossed by House as amended
Read second time
Read first time
Reported from Labor and Commerce with amendment(s) (15-Y 7-N)
Subcommittee failed to recommend reporting (4-Y 5-N)
Subcommittee recommends reporting with amendment(s) (6-Y 3-N)
Reconsidered by Labor and Commerce (Voice Vote)
Assigned HCL sub: Subcommittee #1
Referred to Committee on Labor and Commerce
Prefiled and ordered printed; Offered 01-14-2026 26101225D
Get a plain-English explanation of what this bill does, who it affects, and why it matters.
Conference report agreed to by Senate (39-Y 0-N 0-A)
Rozia A. Henson, Jr.
Dan I. Helmer