To enact section 3902.65 of the Revised Code to cap cost sharing for prescription insulin drugs.
Summary
SB 227 would add a new section to the Ohio Revised Code to limit out-of-pocket cost sharing for prescription insulin drugs. For any health benefit plan amended, issued, or renewed on or after the bill’s effective date, a health plan issuer that covers insulin would be prohibited from charging more than $35 for a 30-day supply of a covered prescription insulin drug. The cap would apply regardless of the amount or type of insulin needed to fill the prescription, and the charge would be assessed on a per-prescription-fill basis.
The bill is narrowly focused on insulin affordability for people with diabetes and does not appear to change coverage requirements beyond the cost-sharing limit. It would apply to health plans subject to Ohio insurance law and would override a referenced existing provision, section 3901.71, to the extent necessary to enforce the insulin cap. In practical terms, the bill would reduce monthly insulin costs for insured patients whose plans currently impose higher copays, coinsurance, or other cost-sharing amounts.
Impact
SB 227 would create a new statutory limit on cost sharing for insulin in Ohio health benefit plans, affecting health plan issuers, insurers, and enrollees who use insulin to treat diabetes. It would require covered plans renewed or issued after the effective date to cap a patient’s share of the cost at $35 per 30-day supply, which could lower prescription expenses for many insured diabetics and require insurers to adjust plan design, claims processing, and pharmacy benefit administration. The bill would amend Ohio insurance law by adding section 3902.65 and would operate notwithstanding section 3901.71.
Sentiment
Based on the bill’s text and the absence of recorded committee testimony or votes, the apparent sentiment is supportive and consumer-focused. The bill’s sponsors and cosponsors suggest interest in addressing insulin affordability and reducing financial barriers for people with diabetes. No opposing arguments, amendments, or recorded votes are provided in the available materials, so there is no documented committee controversy in the record supplied.
Contention
No specific contention is documented in the provided transcripts or voting history, because none are included. Potential areas of debate, if raised later, would likely involve the $35 cap amount, whether the limit should apply per prescription fill regardless of insulin quantity or type, and the cost implications for insurers and premium rates. As introduced, however, the bill record supplied does not identify any named opponents or disputed provisions.