West Virginia 2023 Regular Session

West Virginia House Bill HB2430

Introduced
1/11/23  

Caption

To reduce copay cap on insulin and devices

Impact

The legislation, if passed, is expected to significantly improve access to diabetes care for residents of West Virginia, ensuring that individuals relying on insulin and diabetes management devices can afford their medications without severe financial strain. This amendment specifically adds coverage requirements for health insurance plans, mandating that they include various types of insulin and necessary devices for both insulin-dependent and non-insulin-dependent diabetes cases. Furthermore, it reinforces the importance of diabetes self-management education as part of the care process. Critics and supporters have acknowledged the bill's potential to alleviate healthcare burdens, particularly amidst rising insulin prices, which can create disparities in health outcomes for those with diabetes.

Summary

House Bill 2430 aims to amend the existing West Virginia code to address issues related to diabetes by introducing measures to reduce copayments for insulin and related medical devices. The bill seeks to cap the out-of-pocket costs for prescription insulin drugs at $35 for a 30-day supply and $100 for diabetes equipment, which advocates argue will make essential treatments more affordable for the approximately 240,000 West Virginians diagnosed with diabetes. This bill reflects a growing concern over the escalating costs associated with diabetes management, where many individuals face exorbitant out-of-pocket expenses that can exceed $1,000 monthly, leading to potentially dangerous rationing of insulin.

Sentiment

Overall, the sentiment surrounding HB2430 appears to be supportive, particularly among advocates for public health who view it as a crucial step towards ensuring that diabetic patients receive necessary treatments without financial hardship. However, there are concerns among some legislators and stakeholders about the implications of such mandates on health insurance providers, including how they will adjust to cover these newly stipulated costs without raising premiums. The discussion reflects a broader societal debate about healthcare access, affordability, and the role of government in regulating insurance practices to protect vulnerable populations.

Contention

Despite the positive outlook, notable contention exists regarding the potential implementation challenges. Opposition voices argue that while the intentions behind the bill are commendable, there could be unintended consequences for insurers and healthcare providers, who may struggle to comply with the new coverage mandates. The balance between enhancing access to essential medications and maintaining the financial viability of health plans is a critical point of concern. Moreover, the lack of provisions regarding the reimbursement rates for pharmacies has raised questions about how these changes will affect the overall healthcare system and its sustainability.

Companion Bills

WV SB577

Similar To Reducing copay cap on insulin and devices and permitting purchase of testing equipment without prescription

Previously Filed As

WV SB2010

Reducing copay cap on insulin and devices

WV HB4252

To reduce copay cap on insulin and devices

WV SB577

Reducing copay cap on insulin and devices and permitting purchase of testing equipment without prescription

WV SB238

Requiring health insurance coverage for persons with diabetes

WV HB4274

Renaming the Department of Health and Human Resources

WV S301

Provides that purchase of insulin is not subject to deductible and requires health insurers to limit copayments and coinsurance for insulin.

WV HB1397

Health Insurance - Prescription Insulin Drugs - Limits on Copayment and Coinsurance (Insulin Cost Reduction Act)

WV SB353

Health Insurance - Prescription Insulin Drugs - Limits on Copayment and Coinsurance (Insulin Cost Reduction Act)

WV A553

Provides that purchase of insulin is not subject to deductible; requires health insurers to limit copayments and coinsurance for insulin; requires insulin manufacturers to submit report to Commissioner of Banking and Insurance.

WV A1439

Provides that purchase of insulin is not subject to deductible; requires health insurers to limit copayments and coinsurance for insulin; requires insulin manufacturers to submit report to Commissioner of Banking and Insurance.

Similar Bills

CA AB852

Health care practitioners: electronic prescriptions.

CA AB2789

Health care practitioners: prescriptions: electronic data transmission.

CA AB2863

Health care coverage: prescriptions.

IA SF383

A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.

CA AB577

Health care coverage: antisteering.

IA HF852

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(Formerly HSB 99.)

IA SSB1074

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See SF 383.)

IA HSB99

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See HF 852.)