VirginiaHB7952026 Regular SessionHouseWALLET

Health insurance; requirements for certain opioid antagonists.

Sponsored By: Atoosa R. Reaser (Democratic)

Became Law

Summary

Health insurance; requirements for certain opioid antagonists. Requires each health insurer, corporation providing health care subscription plans, and health maintenance organization whose policy, contract, or plan includes coverage for prescription drugs to include coverage for at least one other opioid antagonist used for overdose reversal dispensed pursuant to an oral, written, or standing order of a prescriber and ensure that cost-sharing for at least one opioid antagonist used for overdose reversal is included on the lowest cost tier of the insurer's, corporation's, or health maintenance organization's prescription drug formulary. The bill provides that such coverage shall be exempt from any prior authorization or step therapy requirement on coverage of benefits. As introduced, this bill was a recommendation of the Joint Commission on Health Care. This bill is identical to SB 257.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 1 benefits, 1 costs, 0 mixed.

Plans must cover overdose reversal drugs

Beginning January 1, 2027, many Virginia health plans must cover at least one opioid overdose reversal drug. Coverage applies when a prescriber gives an oral, written, or standing order. The plan must put cost-sharing for at least one of these drugs on the lowest tier. Plans cannot require prior authorization or step therapy for this coverage. The rule applies to individual or group accident and sickness policies, subscription contracts, and HMO plans that offer major medical coverage.

Plans excluded from overdose drug mandate

Beginning January 1, 2027, some plans are not covered by this rule. Short-term travel, accident-only, limited or specified disease, Medicare or similar government plans, and short-term nonrenewable policies of six months or less are excluded. Also, in the individual and small-group markets, if the state's essential health benefits benchmark already includes this drug benefit, the state mandate does not add another requirement for that part. People with only excluded plans do not get the new coverage or utilization protections.

Sponsors & Cosponsors

Sponsor

  • Atoosa R. Reaser

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 437 • No: 0

House vote 3/12/2026

Senate substitute agreed to by House

Yes: 96 • No: 0

Senate vote 3/11/2026

Passed Senate with substitute Block Vote

Yes: 39 • No: 0

Senate vote 3/11/2026

Commerce and Labor Substitute agreed to

Yes: 0 • No: 0

Senate vote 3/11/2026

Reconsideration of Senate passage agreed to by Senate Block Vote

Yes: 40 • No: 0

Senate vote 3/11/2026

Passed Senate with substitute Block Vote

Yes: 40 • No: 0

Senate vote 3/10/2026

Passed by for the day Block Vote (Voice Vote)

Yes: 0 • No: 0

Senate vote 3/10/2026

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 37 • No: 0

Senate vote 3/9/2026

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

Yes: 15 • No: 0

Senate vote 3/9/2026

Reported from Finance and Appropriations

Yes: 14 • No: 0

House vote 2/13/2026

Read third time and passed House Block Vote

Yes: 96 • No: 0

House vote 2/9/2026

Subcommittee recommends reporting

Yes: 7 • No: 0 • Other: 1

House vote 2/9/2026

Reported from Appropriations

Yes: 22 • No: 0

House vote 2/5/2026

Reported from Labor and Commerce with substitute and referred to Appropriations

Yes: 22 • No: 0

House vote 2/3/2026

Subcommittee recommends reporting with substitute

Yes: 9 • No: 0 • Other: 1

House vote 1/27/2026

Referred from Health and Human Services and referred to Labor and Commerce (Voice Vote)

Yes: 0 • No: 0

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0423)

    4/8/2026Governor
  2. Approved by Governor-Chapter 423 (effective 7/1/2026)

    4/8/2026Governor
  3. Fiscal Impact Statement from Department of Planning and Budget (HB795)

    4/1/2026House
  4. Governor's Action Deadline 11:59 p.m., April 13, 2026

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

    3/31/2026House
  6. Signed by Speaker

    3/31/2026House
  7. Bill text as passed House and Senate (HB795ER)

    3/30/2026House
  8. Enrolled

    3/30/2026House
  9. Signed by President

    3/30/2026Senate
  10. Senate substitute agreed to by House (96-Y 0-N 0-A)

    3/12/2026House
  11. Passed Senate with substitute Block Vote (40-Y 0-N 0-A)

    3/11/2026Senate
  12. Reconsideration of Senate passage agreed to by Senate Block Vote (40-Y 0-N 0-A)

    3/11/2026Senate
  13. Passed Senate with substitute Block Vote (39-Y 0-N 0-A)

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

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

    3/11/2026Senate
  16. Read third time

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

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

    3/10/2026Senate
  19. Fiscal Impact Statement from Department of Planning and Budget (HB795)

    3/10/2026House
  20. Rules suspended

    3/10/2026Senate
  21. Committee substitute printed 26109503D-S1

    3/9/2026Senate
  22. Senate committee offered

    3/9/2026Senate
  23. Reported from Finance and Appropriations (14-Y 0-N)

    3/9/2026Senate
  24. Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations (15-Y 0-N)

    3/9/2026Senate
  25. Referred to Committee on Commerce and Labor

    2/16/2026Senate

Bill Text

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