Fabio
120 lines
9.9 KiB
Markdown
120 lines
9.9 KiB
Markdown
---
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type: "Bill"
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title: "Health insurance; limit on cost-sharing payments for prescription drugs under certain plans."
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description: "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."
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jurisdiction: "us/states/va"
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legislature: "Virginia General Assembly"
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session: "2026"
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identifier: "HB 625"
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citation: "Virginia HB 625 (2026)"
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classification: ["bill"]
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subjects: []
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status: "enacted"
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primary_sponsors: ["Rozia A. Henson, Jr."]
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version_count: 9
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action_count: 44
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vote_count: 11
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first_action: "2026-01-13"
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last_action: "2026-04-13"
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source: "openstates"
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source_identifier: "ocd-bill/e5ce5c44-4558-4b5d-93a3-6511f01bcdbc"
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source_url: "https://lis.virginia.gov/bill-details/20261/HB625"
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source_hash: "0ad9bd4ea0415293148e811f0cdbb43e9d1912127636b779bc2559a7043a3157"
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vintage: "2026-07-01"
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source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
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retrieved_at: "2026-07-06"
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confidence: "reported"
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tags: ["legislation", "bill", "us-va"]
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---
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# Virginia HB 625 (2026) — Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.
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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.
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## Version chain
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The bill's text revisions, in order — the diff chain from filing to enrollment.
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1. **Introduced** (filed) — [source](https://lis.blob.core.windows.net/files/1085250.PDF)
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2. **Chaptered** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1221441.PDF)
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3. **Commerce and Labor Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1177697.PDF)
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4. **Conference Report** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1202421.HTML)
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5. **Conference Report Substitute** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1202381.PDF)
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6. **Engrossed** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1133138.PDF)
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7. **Labor and Commerce Amendment** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1129899.HTML)
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8. **Subcommittee #1 Subcommittee Amendment** (committee substitute) — [source](https://lis.blob.core.windows.net/files/1115878.HTML)
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9. **Enrolled** (enrolled) — [source](https://lis.blob.core.windows.net/files/1213626.PDF)
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## Votes
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- Reported from Labor and Commerce with amendment(s) — **15–7** (pass) · lower
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- H VOTE: — **63–33** (pass) · lower
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- Adopt Conference Committee Report R — **39–0** (pass) · upper
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- Constitutional reading dispensed (on 2nd reading) — **40–0** (pass) · upper
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- Subcommittee recommends reporting with amendment(s) — **6–3** (pass) · lower
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- Passage R — **37–3** (pass) · upper
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- Subcommittee recommends reporting — **4–5** (fail) · lower
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- Insist & Request R — **40–0** (pass) · upper
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- H VOTE: — **63–35** (pass) · lower
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- H VOTE: — **2–97** (fail) · lower
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- Reported from Commerce and Labor with substitute — **11–4** (pass) · upper
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## Sponsors
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- Rozia A. Henson, Jr. — primary (person)
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- Dan I. Helmer — cosponsor (person)
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## Timeline
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The legislative action history — every referral, reading, and vote.
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- **2026-01-13** Prefiled and ordered printed; Offered 01-14-2026 26101225D `filing, introduction`
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- **2026-01-13** Referred to Committee on Labor and Commerce `referral-committee`
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- **2026-01-20** Assigned HCL sub: Subcommittee #1 `referral-committee`
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- **2026-02-03** Subcommittee failed to recommend reporting (4-Y 5-N) `committee-failure`
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- **2026-02-03** Reconsidered by Labor and Commerce (Voice Vote)
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- **2026-02-03** Subcommittee recommends reporting with amendment(s) (6-Y 3-N)
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- **2026-02-05** Reported from Labor and Commerce with amendment(s) (15-Y 7-N) `committee-passage`
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- **2026-02-09** Read first time `reading-1`
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- **2026-02-10** Read second time `reading-2`
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- **2026-02-10** committee amendment agreed to `amendment-passage`
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- **2026-02-10** Engrossed by House as amended
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- **2026-02-11** Read third time and passed House (63-Y 35-N 0-A) `passage, reading-3`
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- **2026-02-12** Constitutional reading dispensed (on 1st reading)
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- **2026-02-12** Referred to Committee on Commerce and Labor `referral-committee`
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- **2026-02-23** Reported from Commerce and Labor with substitute (11-Y 4-N) `committee-passage`
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- **2026-02-24** Committee substitute printed 26108395D-S1 `substitution`
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- **2026-02-25** Rules suspended
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- **2026-02-25** Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
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- **2026-02-25** Passed by for the day Block Vote (Voice Vote)
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- **2026-02-26** Read third time `reading-3`
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- **2026-02-26** Commerce and Labor Substitute agreed to
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- **2026-02-26** Engrossed by Senate - committee substitute `substitution`
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- **2026-02-26** Passed Senate with substitute (37-Y 3-N 0-A) `passage`
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- **2026-03-02** Senate substitute rejected by House (2-Y 97-N 0-A)
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- **2026-03-04** Fiscal Impact Statement from State Corporation Commission (HB625)
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- **2026-03-04** Senate insisted on amendment (40-Y 0-N 0-A)
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- **2026-03-04** Senate requested conference committee `referral-committee`
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- **2026-03-05** House acceded to request
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- **2026-03-06** Conferees appointed by Senate
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- **2026-03-06** Senate Conferees: Perry, Rouse, Stanley
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- **2026-03-09** Conferees appointed by House
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- **2026-03-09** House Conferees: Henson, Ward, McLaughlin
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- **2026-03-10** Conference Report released
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- **2026-03-10** Conference report agreed to by House (63-Y 33-N 0-A) `committee-passage-favorable`
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- **2026-03-11** Conference report agreed to by Senate (39-Y 0-N 0-A) `committee-passage-favorable`
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- **2026-03-30** Enrolled `enrolled`
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- **2026-03-30** Bill text as passed House and Senate (HB625ER) `passage`
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- **2026-03-30** Signed by President `passage`
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- **2026-03-31** Signed by Speaker `passage`
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- **2026-03-31** Enrolled Bill communicated to Governor on March 31, 2026 `enrolled, executive-receipt`
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- **2026-03-31** Governor's Action Deadline 11:59 p.m., April 13, 2026 `executive-receipt`
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- **2026-04-13** Fiscal Impact Statement from State Corporation Commission (HB625)
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- **2026-04-13** Approved by Governor-Chapter 641 (effective 7/1/2026) `executive-signature`
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- **2026-04-13** Acts of Assembly Chapter text (CHAP0641)
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## Source
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OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/e5ce5c44-4558-4b5d-93a3-6511f01bcdbc`. Confidence: reported (aggregated from official Virginia legislature records).
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