Requires insurance coverage for one rescue and one maintenance inhaler at no cost.
Summary
A00128 would require New York health insurance policies that cover prescription drugs to also cover inhalers used to treat asthma, when prescribed by a licensed health care provider. The bill requires coverage of one rescue inhaler and one maintenance inhaler, and it bars insurers from applying deductibles, copayments, coinsurance, or other cost-sharing requirements to that coverage.
The mandate applies to individual, group, blanket, and health service or medical expense indemnity coverage that provides medical, major medical, or similar comprehensive coverage. The bill also includes a limited exception for high-deductible health plans: if fully eliminating cost-sharing would jeopardize a member’s eligibility for a health savings account, the coverage may be subject to the plan’s annual deductible. The act would take effect January 1, 2027, and would apply to policies and contracts issued, renewed, modified, altered, or amended on or after that date.
Impact
The bill amends multiple sections of the New York Insurance Law, including provisions governing individual policies, group or blanket policies, and health service or medical expense indemnity coverage. It creates a new statewide insurance coverage requirement for asthma inhalers and standardizes the benefit across major categories of regulated health plans. Insurers would need to update covered drug formularies and benefit designs to ensure at least one rescue inhaler and one maintenance inhaler are available without cost-sharing, subject only to the high-deductible health plan/HSA exception.
Sentiment
The available voting history shows strong bipartisan support for the bill. It advanced out of the Assembly Insurance Committee 22-2, passed the Assembly Rules Committee unanimously, and then received overwhelming final passage in the Assembly 145-0. The Senate floor vote was also strongly favorable at 56-2. No committee transcript is available, but the vote margins suggest broad agreement that the bill addresses an important access-to-care issue.
Contention
The main policy issue is cost-sharing: the bill eliminates out-of-pocket costs for asthma inhalers, which is likely to be welcomed by patients, advocates, and providers concerned about medication adherence and affordability, but may be viewed by insurers as a mandated benefit that increases plan costs. The only explicit statutory compromise is the high-deductible health plan exception tied to health savings account eligibility, indicating concern about preserving federal tax-advantaged HSA status. The small number of dissenting votes suggests limited opposition, but any resistance likely centered on insurance mandate costs and plan design flexibility.
Expands coverage for the treatment of asthma to include a second rescue and maintenance inhaler, along with any medically necessary devices for children under nineteen years of age.
Expands coverage for the treatment of asthma to include a second rescue and maintenance inhaler, along with any medically necessary devices for children under nineteen years of age.
Relates to including rescue inhaler prescriptions for asthma and other chronic respiratory diseases for individuals under age nineteen in the statewide immunization information system.