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SENATE BILL 443
57
TH LEGISLATURE
-
STATE
OF
NEW
MEXICO
-
FIRST SESSION
,
2025
INTRODUCED BY
Martin Hickey
AN ACT
RELATING TO INSURANCE; AMENDING THE HEALTH CARE PURCHASING ACT
AND SECTIONS OF THE NEW MEXICO INSURANCE CODE TO PROHIBIT COST
SHARING FOR CHOLESTEROL-LOWERING DRUGS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. A new section of the Health Care Purchasing
Act is enacted to read:
"[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--
A. Group health coverage, including any form of
self-insurance, offered, issued or renewed under the Health Care
Purchasing Act that provides coverage for cholesterol-lowering
drugs shall not impose cost sharing on those drugs.
B. For the purposes of this section, "cost sharing"
means a copayment, coinsurance, a deductible or any other form
of financial obligation of an enrollee other than a premium or a
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share of a premium, or any combination of any of these
financial obligations, as defined by the terms of a group
health plan."
SECTION 2. A new section of Chapter 59A, Article 22 NMSA
1978 is enacted to read:
"[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--
A. An individual or group health insurance policy,
health care plan or certificate of health insurance that is
delivered, issued for delivery or renewed in this state that
provides coverage for cholesterol-lowering drugs shall not
impose cost sharing on those drugs.
B. For the purposes of this section, "cost
sharing" means a copayment, coinsurance, a deductible or any
other form of financial obligation of the insured other than a
premium or a share of a premium, or any combination of any of
these financial obligations, as defined by the terms of an
individual or group health insurance policy, health care plan
or certificate of health insurance."
SECTION 3. A new section of Chapter 59A, Article 23 NMSA
is enacted to read:
"[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--
A. A group or blanket health insurance policy,
health care plan or certificate of health insurance that is
delivered, issued for delivery or renewed in this state that
provides coverage for cholesterol-lowering drugs shall not
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impose cost sharing on those drugs.
B. For the purposes of this section, "cost sharing"
means a copayment, coinsurance, a deductible or any other form
of financial obligation of a covered person other than a
premium or a share of a premium, or any combination of any of
these financial obligations, as defined by the terms of a group
or blanket health insurance policy, health care plan or
certificate of health insurance."
SECTION 4. A new section of the Health Maintenance
Organization Law is enacted to read:
"[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--
A. An individual or group health maintenance
organization contract that is delivered, issued for delivery or
renewed in this state that provides coverage for cholesterol-
lowering drugs shall not impose cost sharing on those drugs.
B. For the purposes of this section, "cost sharing"
means a copayment, coinsurance, a deductible or any other form
of financial obligation of an enrollee other than a premium or
a share of a premium, or any combination of any of these
financial obligations, as defined by the terms of an individual
or group health maintenance organization contract."
SECTION 5. A new section of the Nonprofit Health Care
Plan Law is enacted to read:
"[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--
A. An individual or group health care plan that is
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delivered, issued for delivery or renewed in this state that
provides coverage for cholesterol-lowering drugs shall not
impose cost sharing on those drugs.
B. For the purposes of this section, "cost sharing"
means a copayment, coinsurance, a deductible or any other form
of financial obligation of a subscriber other than a premium or
a share of a premium, or any combination of any of these
financial obligations, as defined by the terms of an individual
or group health care plan."
SECTION 6. EFFECTIVE DATE.--The effective date of the
provisions of this act is January 1, 2026.
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