# Virginia HB625: Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

Virginia HB625, Health insurance; limit on cost-sharing payments for prescription drugs under certain plans., is a 2026 Regular Session House bill sponsored by Rozia A. Henson, Jr. (Democratic); status signed, last action 2026-04-13 (Fiscal Impact Statement from State Corporation Commission (HB625)); PRIA reads it as touching household money (as of 2026-10-12).

- Canonical: https://policyrisk.com/state-bill/VA-HB625-2026
- As of: 2026-10-12
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: Virginia HB625
- State: Virginia
- Session: 2026 Regular Session
- Title: Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.
- Status: signed
- Chamber: House
- Introduced: 2026-01-13
- Last action: 2026-04-13, Fiscal Impact Statement from State Corporation Commission (HB625)
- Sponsor: Rozia A. Henson, Jr. (Democratic)
- Cosponsors: 0
- Touches household money: yes
- Roll calls: 14 (320 yes, 187 no in all)
- Economic provisions PRIA read: 2

## Summary

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.

## Bill overview: provisions PRIA read

- Drug cost caps in individual and small-group plans: benefit, medium. Starting January 1, 2028, carriers in Virginia must offer at least one capped plan in each metal level in every rating area for the individual and small-group markets. These plans cap what you pay at the pharmacy per 30-day fill: platinum $150, gold $200, silver $250, bronze $300. The caps apply ev…
- HSA plans: caps start after deductible: mixed, low. If your plan is HSA-qualified, the drug cost caps do not apply to the deductible until you meet the federal minimum deductible. After you meet it, the caps apply. This preserves your plan’s HSA eligibility. The rule applies to plans delivered, issued, or renewed on or after January 1, 2028.

## Sponsors and cosponsors

- Sponsor: Rozia A. Henson, Jr. (Democratic), House

## Roll call votes

| Date | Chamber | Motion | Result | Yes | No | Other |
| --- | --- | --- | --- | --- | --- | --- |
| 2026-03-11 | Senate | Conference report agreed to by Senate | pass | 39 | 0 |   |
| 2026-03-10 | House | Conference report agreed to by House | pass | 63 | 33 |   |
| 2026-03-04 | Senate | Senate insisted on amendment Block Vote | pass | 40 | 0 |   |
| 2026-03-02 | House | Senate substitute rejected by House | fail | 2 | 97 |   |
| 2026-02-26 | Senate | Commerce and Labor Substitute agreed to | pass | 0 | 0 |   |
| 2026-02-26 | Senate | Passed Senate with substitute | pass | 37 | 3 |   |
| 2026-02-25 | Senate | Constitutional reading dispensed Block Vote (on 2nd reading) | pass | 40 | 0 |   |
| 2026-02-25 | Senate | Passed by for the day Block Vote (Voice Vote) | pass | 0 | 0 |   |
| 2026-02-23 | Senate | Reported from Commerce and Labor with substitute | pass | 11 | 4 |   |
| 2026-02-11 | House | Read third time and passed House | pass | 63 | 35 |   |
| 2026-02-05 | House | Reported from Labor and Commerce with amendment(s) | pass | 15 | 7 |   |
| 2026-02-03 | House | Reconsidered by Labor and Commerce (Voice Vote) | pass | 0 | 0 |   |
| 2026-02-03 | House | Subcommittee failed to recommend reporting | fail | 4 | 5 |   |
| 2026-02-03 | House | Subcommittee recommends reporting with amendment(s) | pass | 6 | 3 |   |

## Actions (44)

- 2026-04-13: Fiscal Impact Statement from State Corporation Commission (HB625) (House)
- 2026-04-13: Acts of Assembly Chapter text (CHAP0641) (Governor)
- 2026-04-13: Approved by Governor-Chapter 641 (effective 7/1/2026) (Governor)
- 2026-03-31: Governor's Action Deadline 11:59 p.m., April 13, 2026 (Governor)
- 2026-03-31: Enrolled Bill communicated to Governor on March 31, 2026 (House)
- 2026-03-31: Signed by Speaker (House)
- 2026-03-30: Bill text as passed House and Senate (HB625ER) (House)
- 2026-03-30: Enrolled (House)
- 2026-03-30: Signed by President (Senate)
- 2026-03-11: Conference report agreed to by Senate (39-Y 0-N 0-A) (Senate)
- 2026-03-10: Conference report agreed to by House (63-Y 33-N 0-A) (House)
- 2026-03-10: Conference Report released
- 2026-03-09: House Conferees: Henson, Ward, McLaughlin (House)
- 2026-03-09: Conferees appointed by House (House)
- 2026-03-06: Senate Conferees: Perry, Rouse, Stanley (Senate)
- 2026-03-06: Conferees appointed by Senate (Senate)
- 2026-03-05: House acceded to request (House)
- 2026-03-04: Senate insisted on amendment Block Vote (40-Y 0-N 0-A) (Senate)
- 2026-03-04: Fiscal Impact Statement from State Corporation Commission (HB625) (House)
- 2026-03-04: Senate requested conference committee (Senate)
- 2026-03-02: Senate substitute rejected by House (2-Y 97-N 0-A) (House)
- 2026-02-26: Passed Senate with substitute (37-Y 3-N 0-A) (Senate)
- 2026-02-26: Commerce and Labor Substitute agreed to (Senate)
- 2026-02-26: Engrossed by Senate - committee substitute (Senate)
- 2026-02-26: Read third time (Senate)
- 2026-02-25: Passed by for the day Block Vote (Voice Vote) (Senate)
- 2026-02-25: Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A) (Senate)
- 2026-02-25: Rules suspended (Senate)
- 2026-02-24: Committee substitute printed 26108395D-S1 (Senate)
- 2026-02-23: Reported from Commerce and Labor with substitute (11-Y 4-N) (Senate)
- 2026-02-12: Referred to Committee on Commerce and Labor (Senate)
- 2026-02-12: Constitutional reading dispensed (on 1st reading) (Senate)
- 2026-02-11: Read third time and passed House (63-Y 35-N 0-A) (House)
- 2026-02-10: Engrossed by House as amended (House)
- 2026-02-10: committee amendment agreed to (House)
- 2026-02-10: Read second time (House)
- 2026-02-09: Read first time (House)
- 2026-02-05: Reported from Labor and Commerce with amendment(s) (15-Y 7-N) (House)
- 2026-02-03: Subcommittee recommends reporting with amendment(s) (6-Y 3-N) (House)
- 2026-02-03: Reconsidered by Labor and Commerce (Voice Vote) (House)
- 2026-02-03: Subcommittee failed to recommend reporting (4-Y 5-N) (House)
- 2026-01-20: Assigned HCL sub: Subcommittee #1 (House)
- 2026-01-13: Referred to Committee on Labor and Commerce (House)
- 2026-01-13: Prefiled and ordered printed; Offered 01-14-2026 26101225D (House)

## Bill text

- Chaptered, 2026-04-13: [HTML](https://lis.blob.core.windows.net/files/1221442.HTML), [PDF](https://lis.blob.core.windows.net/files/1221441.PDF)
- Enrolled, 2026-03-30: [HTML](https://lis.blob.core.windows.net/files/1213627.HTML), [PDF](https://lis.blob.core.windows.net/files/1213626.PDF)
- Conference Report, 2026-03-10: [HTML](https://lis.blob.core.windows.net/files/1202421.HTML)
- Substitute, 2026-03-10: [HTML](https://lis.blob.core.windows.net/files/1202382.HTML), [PDF](https://lis.blob.core.windows.net/files/1202381.PDF)
- Substitute, 2026-02-24: [HTML](https://lis.blob.core.windows.net/files/1177698.HTML), [PDF](https://lis.blob.core.windows.net/files/1177697.PDF)
- Engrossed, 2026-02-10: [HTML](https://lis.blob.core.windows.net/files/1133139.HTML), [PDF](https://lis.blob.core.windows.net/files/1133138.PDF)
- Amendment, 2026-02-05: [HTML](https://lis.blob.core.windows.net/files/1129899.HTML)
- Amendment, 2026-02-04: [HTML](https://lis.blob.core.windows.net/files/1115878.HTML)
- Introduced, 2026-01-13: [HTML](https://lis.blob.core.windows.net/files/1085251.HTML), [PDF](https://lis.blob.core.windows.net/files/1085250.PDF)

## Related bills

- HB5: Employment; paid sick leave, civil penalties. (signed)
- SB199: Employment; paid sick leave, civil penalties. (signed)
- HB95: Va. Residential Landlord and Tenant Act; landlord remedies, noncompliance with rental agreement. (signed)
- HB1393: Electric utilities; pilot program for energy assistance and weatherization for certain individuals. (signed)
- HB834: Virginia Residential Landlord and Tenant Act; fire or casualty damage, termination by landlord. (signed)
- HB675: Protection of employees; coercion or threat based on immigration status, civil penalty. (signed)

## Sources
- [Chaptered (HTML)](https://lis.blob.core.windows.net/files/1221442.HTML)
- [Chaptered (PDF)](https://lis.blob.core.windows.net/files/1221441.PDF)
- [Enrolled (HTML)](https://lis.blob.core.windows.net/files/1213627.HTML)
- [Enrolled (PDF)](https://lis.blob.core.windows.net/files/1213626.PDF)
- [Conference Report (HTML)](https://lis.blob.core.windows.net/files/1202421.HTML)
- [Substitute (HTML)](https://lis.blob.core.windows.net/files/1202382.HTML)
- [Substitute (PDF)](https://lis.blob.core.windows.net/files/1202381.PDF)
- [Substitute (HTML)](https://lis.blob.core.windows.net/files/1177698.HTML)
- [Substitute (PDF)](https://lis.blob.core.windows.net/files/1177697.PDF)
- [Engrossed (HTML)](https://lis.blob.core.windows.net/files/1133139.HTML)
- [Engrossed (PDF)](https://lis.blob.core.windows.net/files/1133138.PDF)
- [Amendment (HTML)](https://lis.blob.core.windows.net/files/1129899.HTML)
- [Amendment (HTML)](https://lis.blob.core.windows.net/files/1115878.HTML)
- [Introduced (HTML)](https://lis.blob.core.windows.net/files/1085251.HTML)
- [Introduced (PDF)](https://lis.blob.core.windows.net/files/1085250.PDF)

## Related
- [HB5: Employment; paid sick leave, civil penalties.](https://policyrisk.com/state-bill/VA-HB5-2026)
- [SB199: Employment; paid sick leave, civil penalties.](https://policyrisk.com/state-bill/VA-SB199-2026)
- [HB95: Va. Residential Landlord and Tenant Act; landlord remedies, noncompliance with…](https://policyrisk.com/state-bill/VA-HB95-2026)
- [HB1393: Electric utilities; pilot program for energy assistance and weatherization for…](https://policyrisk.com/state-bill/VA-HB1393-2026)
- [HB834: Virginia Residential Landlord and Tenant Act; fire or casualty damage, terminat…](https://policyrisk.com/state-bill/VA-HB834-2026)
- [HB675: Protection of employees; coercion or threat based on immigration status, civil…](https://policyrisk.com/state-bill/VA-HB675-2026)
- [Virginia bills](https://policyrisk.com/states/virginia/bills)
- [Virginia state hub](https://policyrisk.com/states/virginia)
- [All state legislation](https://policyrisk.com/state-bills)

Source: PRIA, https://policyrisk.com/state-bill/VA-HB625-2026 (as of 2026-10-12).