HB 1941 Missouri House · 2026 Regular Session

Creates provisions relating to cost-sharing under health benefit plans

HB 1941 requires health insurance plans in Missouri to count payments for non-generic medications toward a patient's annual out-of-pocket maximum. Specifically, health carriers must include costs paid by enrollees for medications where a generic version is unavailable when calculating this limit. The bill also prohibits plans from adjusting cost-sharing requirements based on the availability of cost-assistance programs for such medications. This directly affects patients using non-generic prescription drugs who would otherwise face unexpectedly high out-of-pocket expenses. The law applies to most health benefit plans starting August 28, 2026.

Issues: ✓ Healthcare

Bill status in committee 1 of 4 stages cleared

Introduction

Dec 2025

Committee Review

Floor Vote

Governor

Introduced Dec 1, 2025 Last action Apr 29, 2026

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What changed between versions

Introduced → House Committee Substitute · 6 edits

MODERATE

The bill was expanded to include three related bills (1941, 2279, and 1681) instead of just one, and the bill number in the clerk's section was updated to reflect this consolidation. The substantive policy change requires health carriers and pharmacy benefits managers to count the full cost of medications when calculating patient out-of-pocket maximums if a generic drug substitute is not available. Additionally, the bill was amended to explicitly state that federal ERISA laws do not weaken the bill's specific exemptions and to clarify that these rules only apply when generic alternatives are unavailable.

Scope change

The bill now covers three related legislative measures (HB 1941, HB 2279, and HB 1681) rather than a single standalone bill.

SCOPE

The bill title and header were updated to include House Bills 2279 and 1681, indicating these measures are now treated as a single legislative package.

DEFINITION

The bill number reference for the Chief Clerk was changed from 4439H.01I to 4439H.02C.

REQUIREMENT

A new provision requires health carriers and pharmacy benefit managers to include the full cost of non-generic medications in out-of-pocket calculations when no generic substitute exists.

TIMELINE

New language specifies that the bill's provisions apply to plans entered into, amended, extended, or renewed on or after August 28, 2026.

ENFORCEMENT

A new clause clarifies that federal ERISA laws do not alter or weaken the specific exemptions provided in the bill.

ELIGIBILITY

A new provision explicitly limits the application of the cost-sharing rules to instances where a generic drug substitute is not available.

Floor votes

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No floor votes recorded yet.

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Mar 5, 2026

Lower · Passed

Reported Do Pass (H) - AYES: 9 NOES: 3 PRESENT: 0

lower

Mar 5, 2026

Lower · Passed

Voted Do Pass (H)

lower

Feb 18, 2026

Committee

Referred: Rules - Legislative(H)

lower

Feb 12, 2026

Lower · Passed

HCS Reported Do Pass (H) - AYES: 15 NOES: 2 PRESENT: 0

lower

Feb 12, 2026

Lower · Passed

HCS Voted Do Pass (H)

lower

Jan 15, 2026

Committee

Referred: Health and Mental Health(H)

lower

Dec 1, 2025

Introduced

Prefiled (H)

lower

1 primary · 1 co-sponsor