An Act to amend and reenact §§ 38.2-3407.5:1 and 38.2-3407.5:2 of the Code of Virginia, relating to health insurance; coverage for contraceptive drugs and devices.
HB1182 amends Virginia’s health insurance laws to require certain insurers, health service corporations, and health maintenance organizations that already cover outpatient prescription drugs to also offer coverage for FDA-approved contraceptive drugs and devices. The bill expressly includes contraceptives available over the counter, with or without a prescription, and defines key terms such as “contraceptive drug,” “contraceptive device,” “medical need,” and “therapeutically equivalent version.”
The measure also limits how plans may apply cost-sharing and utilization rules. It generally prohibits copayments, coinsurance, fees, or reimbursement reductions that are not applied equally to comparable prescription drug benefits, while allowing cost-sharing for one or more therapeutically equivalent options so long as at least one equivalent option is available without cost-sharing. If a health care provider determines a particular contraceptive is medically necessary, the plan must cover that recommended product without cost-sharing. The bill further bars burdensome restrictions or delays, including requiring a prescription for over-the-counter contraceptives, and requires insurers to provide clear written information about contraceptive coverage on request and on their websites.
HB1182 expands and clarifies mandated contraceptive coverage under Virginia insurance law by amending §§ 38.2-3407.5:1 and 38.2-3407.5:2. It affects individual and group accident and sickness policies, subscription contracts, and health maintenance organization plans that include outpatient prescription drug coverage, while preserving certain limits such as closed formularies and excluding plans that do not otherwise cover prescription drugs. The bill also reinforces access protections by restricting cost-sharing practices and requiring coverage for medically necessary contraceptive options without additional out-of-pocket cost.
The available record shows the bill was enacted as Chapter 1092 and approved on April 22, 2026, indicating it ultimately had sufficient support to become law. No committee transcripts or recorded votes were provided, so there is no direct evidence in the supplied materials of floor debate or organized opposition. Based on the enacted status and the bill’s consumer-coverage focus, the overall sentiment appears to have been favorable enough to secure passage.
The main points of potential contention are the scope of mandated coverage and the limits on insurer discretion. Insurers may object to being required to cover over-the-counter contraceptives, to provide coverage without cost-sharing for medically necessary products, and to avoid administrative barriers such as prescription requirements or extra request procedures. Another possible area of dispute is the interaction with closed formularies and the requirement that formularies include certain contraceptive categories, which may be viewed as constraining plan design. No specific opposing or supporting arguments were included in the provided transcripts.