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HB 625 — Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

VA 20261 session

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 one health plan in each of the bronze, silver, gold, and platinum levels of coverage in each rating area in the individual and small group market conform with the following: (i) a plan that offers a platinum level of coverage shall limit 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; (ii) a plan that offers a gold level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $200 per 30-day supply of the prescription drug; (iii) a plan that offers a silver level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $250 per 30-day supply of the prescription drug; and (iv) a plan that offers a bronze level of coverage shall limit a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $300 per 30-day supply of the prescription drug. 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 carrier. The bill's provisions apply to any individual or group accident and sickness insurance policy, any individual or group accident and sickness subscription contract, and any health care plan for health care services delivered, issued for delivery, or renewed in the Commonwealth on or after January 1, 2028. This bill is identical to SB 161.

Latest action: — Acts of Assembly Chapter

Sponsors (2)
Action timeline (52)
  1. · house · H4020 —
  2. · house · H1401 —
  3. · house · H1412 —
  4. · house · H1416 —
  5. · house · H1413 —
  6. · house · H1417 —
  7. · house · H1407 —
  8. · house · H4110 —
  9. · house · H4120 —
  10. · house · H4210 —
  11. · house · H4602 —
  12. · house · H5000 —
  13. · senate · S4140 —
  14. · senate · S0201 —
  15. · senate · S0208 —
  16. · senate · S4640 —
  17. · senate · S4150 —
  18. · senate · S4145 —
  19. · senate · S4160 —
  20. · senate · S4160 —
  21. · senate · S4130 —
  22. · senate · S4410 —
  23. · senate · S4601 —
  24. · senate · S5022 —
  25. · house · H5432 —
  26. · house · H8500 —
  27. · senate · S5500 —
  28. · senate · S6010 —
  29. · house · H6012 —
  30. · senate · S6011 —
  31. · senate · S6013 —
  32. · senate · S6013 —
  33. · house · H6011 —
  34. · house · H6013 —
  35. · house · H4641 —
  36. · house · H4641 —
  37. · C6038 —
  38. · C6038 —
  39. · house · H6015 —
  40. · senate · S6015 —
  41. · house · H5610 —
  42. · house · H5601 —
  43. · senate · S5620 —
  44. · house · H7010 —
  45. · G7010 —
  46. · house · H5620 —
  47. · house · H7010 —
  48. · G7010 —
  49. · G7050 —
  50. · house · H8500 —
  51. · G7050 —
  52. · G9998 —
Text versions (0)

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Bill text (extracted)
Amendments
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Who matters on this bill

Who matters

Members ranked by combined influence on this bill: role (sponsor 5 / cosponsor 1), capped speech count from the Congressional Record, and recorded-vote engagement.

#MemberRoleSpeechesVotedScore
1Rozia A. Henson, Jr. (D, state_lower VA)sponsor0—5
2Dan I. Helmer (D, state_lower VA)cosponsor0—1
Stance (positions taken)

Predicted vote

Aggregated from: actual roll-call votes (when present) → sponsor → cosponsor → party median (predicts YES when ≥25% of the caucus sponsored/cosponsored). Each row labels its confidence tier so you can see why a position was predicted.

0 predicted yes (0%) · 543 predicted no (100%) · 0 unknown (0%)

By party: · R: 0 yes / 277 no · D: 0 yes / 263 no · I: 0 yes / 3 no

Timeline
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Mentioned in /ask threads

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