Georgia House Bill HB100

Georgia 2025-2026 Regular Session

• Introduced: 1/17/25

Caption

Prescription Drug Consumer Financial Protection Act; enact

Impact

If enacted, HB100 will necessitate changes in how health benefit plans are structured, specifically in regards to the cost-sharing calculations for prescription drugs. Insurers will be required to adjust the price by which enrollees' cost-sharing requirements are determined—reflecting the rebates passed through. This move aims to improve transparency in health care expenses and ensure that consumers are not unduly burdened by high costs, making necessary medications more affordable.

Summary

House Bill 100, formally titled the 'Prescription Drug Consumer Financial Protection Act', was introduced to amend insurance regulations in Georgia. This legislation mandates that all health insurers pass on at least 80 percent of all prescription drug rebates received from third parties directly to enrollees. The intent of the bill is to alleviate the financial burden of high out-of-pocket costs for prescription medications, which has become increasingly problematic for many citizens, particularly those with chronic health conditions. The bill highlights the importance of ensuring that enrollees benefit financially from price concessions traditionally retained by insurers.

Conclusion

As the bill moves through the legislative process, it is likely to encounter further debate regarding its feasibility and impact on the health insurance market in Georgia. The effectiveness of HB100 in achieving its goal of reducing prescription drug costs for enrollees hinges on the cooperation between insurers, regulators, and the pharmaceutical industry. The anticipated effective date of the bill is January 1, 2026, thus implementation strategies will need to be developed well in advance.

Contention

The potential implications of HB100 have spurred a variety of discussions among stakeholders. Proponents assert that the bill is a positive step towards consumer financial protection and equitable access to medications. However, concerns have been raised regarding the ability of insurers to adapt to these requirements, particularly in how they determine and disclose rebate pricing structures. Some critics worry that such regulations may lead to administrative burdens that could be passed onto consumers in other forms, negating the intended financial benefits of the rebates designed for enrollees.