VirginiaHB3282026 Regular SessionHouseWALLET

Health insurance; essential health benefits benchmark plan selection.

Sponsored By: Jen Kiggans - to resign 12/31 (Republican)

Became Law

Summary

Health insurance; essential health benefits benchmark plan. Requires the Bureau of Insurance to select a new essential health benefits benchmark plan for the 2028 plan year, or the soonest plan year thereafter as permitted by the Centers for Medicare and Medicaid Services, that includes, in addition to the essential health benefits package included in the existing benchmark plan, coverage for (i) doula care services; (ii) the treatment of iatrogenic infertility; (iii) fertility treatment and diagnosis, including a maximum of three cycles per lifetime of assisted reproductive technology; (iv) hearing aids for individuals of all ages; (v) pasteurized donor human breast milk; (vi) the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome; and (vii) the treatment of polycystic ovary syndrome. Such mandate for coverage does not apply to the individual or small group markets. The bill has a delayed effective date pursuant to approval by the Centers for Medicare and Medicaid Services of certain coverage as outlined in the bill. As introduced, this bill was a recommendation of the Health Insurance Reform Commission.

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Bill Overview

Analyzed Economic Effects

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

Hearing aids for kids are covered

Health plans subject to this law cover hearing aids for children age 18 or younger. The plan pays up to $1,500 per hearing aid per hearing‑impaired ear every 24 months. You can pick a more expensive device and pay only the extra cost. There are no copays or fees for this benefit. An ear doctor must recommend the device, and it can be provided by an ear doctor, audiologist, or hearing aid specialist. This applies to policies delivered or renewed on or after January 1, 2024. It does not apply to individual or small‑group plans, certain short‑term policies, or Medicare‑type plans.

New essential health benefits for 2028

The Bureau of Insurance selects a new essential health benefits (EHB) benchmark for 2028 or the first year CMS allows. The benchmark must add doula care; infertility diagnosis and treatment, including up to three ART cycles; treatment of iatrogenic infertility and fertility preservation; hearing aids for all ages; pasteurized donor breast milk; PANS/PANDAS care; and treatment for polycystic ovary syndrome. The first enactment tied to this change takes effect on January 1 of the plan year when CMS approves the new benchmark, and the Bureau certifies that approval. For PANS/PANDAS, once that care is part of the EHB benchmark, the separate state mandate does not apply to individual and small‑group plans. The Bureau must alert lawmakers if federal EHB rules change, and a state commission will recommend any needed benefit reductions.

Coverage for PANS and PANDAS care

Health plans subject to this law cover diagnosis and treatment for PANS and PANDAS. Covered care includes antibiotics, medicines, behavioral therapy, immune‑modulating treatments, plasma exchange, and IVIG. Plans cannot deny care because of past treatment or a different prior diagnosis, or force trials that treat symptoms only before immune treatments. Prior authorization can apply, but rules on deductibles and coinsurance must be no stricter than for other illnesses. Plans must cover out‑of‑state care if the service is not available in Virginia. This applies to policies on or after January 1, 2026, or sooner when a term or premium changes. It does not apply to individual or small‑group plans, certain short‑term policies, or Medicare‑type plans.

How the state funds hearing aid coverage

The State Corporation Commission can only use money the legislature specifically appropriates to cover costs related to the hearing aid mandate. It cannot use special‑fund revenues or license and clerk fees for this purpose. Any appropriated money left at year‑end stays with the Commission to pay these costs.

Sponsors & Cosponsors

Sponsor

  • Jen Kiggans - to resign 12/31

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 360 • No: 138

Senate vote 4/22/2026

Senate concurred in Governor's recommendation

Yes: 22 • No: 17

House vote 4/22/2026

House concurred in Governor's recommendation

Yes: 69 • No: 31

House vote 3/12/2026

Senate substitute agreed to by House

Yes: 68 • No: 30

Senate vote 3/11/2026

Passed Senate with substitute

Yes: 24 • No: 16

Senate vote 3/11/2026

Commerce and Labor Substitute agreed to

Yes: 0 • No: 0

Senate vote 3/10/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 3/10/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 3/9/2026

Reported from Finance and Appropriations

Yes: 10 • No: 4

Senate vote 3/2/2026

Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations

Yes: 8 • No: 5

House vote 2/17/2026

Read third time and passed House

Yes: 72 • No: 25

House vote 2/11/2026

Subcommittee recommends reporting

Yes: 7 • No: 0

House vote 2/11/2026

Reported from Appropriations

Yes: 22 • No: 0

House vote 1/29/2026

Reported from Labor and Commerce with amendment(s) and referred to Appropriations

Yes: 15 • No: 7

House vote 1/27/2026

Subcommittee recommends reporting with amendment(s) and referring to Appropriations

Yes: 6 • No: 3

Actions Timeline

  1. Senate concurred in Governor's recommendation (22-Y 17-N 0-A)

    4/22/2026Senate
  2. House concurred in Governor's recommendation (69-Y 31-N 0-A)

    4/22/2026House
  3. Acts of Assembly Chapter text (CHAP1048)

    4/22/2026Governor
  4. Reenrolled bill text (HB328ER2)

    4/22/2026House
  5. Approved by Governor-Chapter 1048 (Effective - see bill)

    4/22/2026Governor
  6. Signed by President

    4/22/2026Senate
  7. Signed by Speaker

    4/22/2026House
  8. Governor's recommendation adopted

    4/22/2026Governor
  9. Governor's recommendation received by House

    4/11/2026Governor
  10. Governor's Action Deadline 11:59 p.m., April 13, 2026

    3/31/2026Governor
  11. Enrolled Bill communicated to Governor on March 31, 2026

    3/31/2026House
  12. Signed by Speaker

    3/31/2026House
  13. Bill text as passed House and Senate (HB328ER)

    3/30/2026House
  14. Enrolled

    3/30/2026House
  15. Signed by President

    3/30/2026Senate
  16. Senate substitute agreed to by House (68-Y 30-N 0-A)

    3/12/2026House
  17. Passed Senate with substitute (24-Y 16-N 0-A)

    3/11/2026Senate
  18. Commerce and Labor Substitute agreed to

    3/11/2026Senate
  19. Engrossed by Senate - committee substitute

    3/11/2026Senate
  20. Read third time

    3/11/2026Senate
  21. Passed by for the day Block Vote (Voice Vote)

    3/10/2026Senate
  22. Constitutional reading dispensed Block Vote (on 2nd reading) (37-Y 0-N 0-A)

    3/10/2026Senate
  23. Rules suspended

    3/10/2026Senate
  24. Reported from Finance and Appropriations (10-Y 4-N)

    3/9/2026Senate
  25. Fiscal Impact Statement from State Corporation Commission (HB328)

    3/5/2026House

Bill Text

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