Texas Senate Bill SB1967

Texas 2017 - 85th Regular

Caption

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

Impact

The legislation is designed to ensure that enrollees retain access to necessary medications without facing abrupt changes in coverage or increased costs upon the renewal of their health plans. This is particularly significant for individuals managing chronic conditions or mental health issues, as it helps secure continuity in their treatment regimens. By restricting harmful modifications that could hinder access to formulated drugs or impose greater financial burdens on users, SB1967 promotes a more stable healthcare experience.

Summary

SB1967 aims to amend the Insurance Code concerning the modification of prescription drug benefits under certain health benefit plans. The bill seeks to enhance the protections for enrollees by limiting the ability of health benefit plan issuers to modify drug coverage in ways that could disadvantage them. Notably, it mandates that, upon renewal of a health benefit plan, issuers cannot change an enrollee's contracted benefit level for any prescription drug that was covered in the prior year and prescribed by a qualified medical professional, provided that the drug is deemed safe and effective.

Contention

While the bill is widely supported for prioritizing the health and stability of enrollees, there are concerns regarding the potential financial implications for insurers. Critics argue that limiting modification abilities might lead to increased operational costs for health benefit plans, which could ultimately be passed on to consumers in the form of higher premiums. The balance between protecting enrollee benefits and maintaining the financial viability of health plans is a point of contention that is anticipated to fuel ongoing debates as the bill progresses.