FloridaHB 6972026HouseWALLET

Drug Prices and Coverage

Sponsored By: Jennifer Kincart Jonsson (Republican)

Signed by Governor

AppropriationHealth Care Facilities & Systems SubcommitteeBudget CommitteeHealth & Human Services CommitteeHouse CalendarRules

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 2 benefits, 0 costs, 2 mixed.

Funding and income rules for HIV help

Florida provides a one-time $30.901933 million from the Grants and Donations Trust Fund for HIV/AIDS medication assistance through June 30, 2026. Through that date, the AIDS Drug Assistance Program’s income limit is 400% of the federal poverty level. The limit uses adjusted gross household income, and other program eligibility requirements still apply. The funding goes to the Department of Health, not directly to participants as cash payments.

Direct HIV medicine help with limits

Through June 30, 2026, Florida must distribute AIDS Drug Assistance Program medicines directly instead of buying health insurance covering HIV/AIDS medicines. The Department of Health must include all drugs on the program’s March 1, 2026 medicine list. Its March 1, 2026 Self-Insured Formulary also stays in effect through at least June 30, 2026. People with creatinine clearance below 60 milliliters per minute must have a clinically suitable medicine available. Within available funding, the department may limit medicine distribution to people below that kidney-function threshold.

Stronger payment protections for pharmacies

Beginning July 1, 2026, pharmacy benefit managers must let pharmacies and pharmacists combine multiple processed claims into one reimbursement appeal. Claims must involve the same drug and days’ supply, with service dates in the same calendar month. Managers cannot stop pharmacies or pharmacists from refusing to dispense when payment is below their actual or expected acquisition cost. They also cannot pay a pharmacy or pharmacist less than they pay an affiliated pharmacy or pharmacist. These rules protect pharmacy payments; they do not set patients’ drug prices or out-of-pocket costs.

PACE-only plans leave pharmacy benefit rules

Beginning July 1, 2026, plans serving only a PACE organization fall outside Florida’s definition of a pharmacy benefits plan or program. Those plans no longer face requirements tied to that definition, including its pharmacy protections. This exemption changes plan obligations rather than providing a direct household payment or benefit.

Sponsors & Cosponsors

Sponsor

Jennifer Kincart Jonsson
Republican • House

Cosponsors

Health & Human Services Committee
Affiliation unavailable

Roll Call Votes

All Roll Calls

Yes: 254 • No: 0

House vote • 3/12/2026

House Floor Vote

Yes: 108 • No: 0

Senate vote • 3/10/2026

Senate Floor Vote

Yes: 38 • No: 0

House vote • 3/5/2026