HB 100 would require health insurers to pass at least 80% of all prescription drug rebates they receive to enrollees. This requirement means that when insurers negotiate discounts and rebates from drug manufacturers, a large portion of those savings must be used to lower out-of-pocket costs for patients at the pharmacy counter.
Key details:
- Rebates are price concessions that drug manufacturers provide to insurers or pharmacy benefit managers (PBMs) in exchange for covering certain medications. Currently, insurers and PBMs do not always pass these savings to consumers.
- Insurers must apply at least 80% of these rebates to reduce the cost-sharing amounts (copays, deductibles, and coinsurance) that patients pay for prescription drugs.
- Insurers who fail to comply could face penalties, including fines or losing their license.
Why it matters: HB 100 aims to lower prescription drug costs for consumers by ensuring that drug rebates benefit patients rather than insurers. The bill could make medications more affordable by requiring insurers to pass along at least 80% of rebates, especially for people with chronic conditions who rely on costly prescriptions. However, some insurers may argue that this policy could lead to higher premiums if they cannot retain a portion of the rebates to offset other costs.