HB 2642 Missouri House · 2026 Regular Session

Creates provisions relating to insurance coverage of alternatives to opioid drugs

HB 2642 requires health insurance plans to cover nonopioid medications for acute pain without barriers, directly affecting people with health insurance (enrollees) and the plans themselves. The law prohibits plans from denying coverage for nonopioid drugs in favor of opioids, forcing patients to try opioids first, or charging higher costs for nonopioid options compared to opioids. It applies only to acute pain (expected to last 30 days or less) and takes effect for plans renewed or issued after January 1, 2027. The bill does not change provider prescribing practices but mandates equal treatment for nonopioid alternatives under insurance coverage.
Bill status passed 3 of 5 stages cleared
Introduction
Jan 2026
Committee Review
Mar 2026
House Passage
Mar 2026
Senate Passage
Governor
Introduced Jan 2, 2026 Last action Mar 31, 2026
Maddy AI version diff · 2 comparisons

What changed between versions

House Committee Substitute Perfected · 2 edits
MINOR
The bill was reclassified from a House Committee Substitute to a Perfected version, indicating it has passed all legislative stages and is ready for final action. A specific provision regarding nonopioid pain medication was removed from the bill text, while the explanatory note clarifying that bracketed text is not enacted remains unchanged.
Scope change
The bill's scope remains focused on health care and prescription drug coverage, but the specific language mandating coverage for nonopioid pain medications was deleted from the text.
REQUIREMENT

A clause requiring health benefit plans to cover nonopioid medications prescribed for acute or chronic pain was removed from the bill text.

TECHNICAL

The bill's internal reference code was updated from 'H.04C' to 'H.04P' to reflect its status as a Perfected version.

Floor votes

How they voted

This bill passed the House by voice vote (no roll call recorded).
Full legislative history

Actions timeline

Total actions
23
Key actions
6
Committee
7
Mar 31, 2026
Committee
Second read and referred: Insurance and Banking(S)
upper
Mar 12, 2026
Lower · Passed
Third Read and Passed (H) - AYES: 138 NOES: 1 PRESENT: 1
lower
Mar 10, 2026
Lower · Passed
HCS Adopted (H)
lower
Feb 17, 2026
Lower · Passed
Reported Do Pass (H) - AYES: 9 NOES: 0 PRESENT: 0
lower
Feb 17, 2026
Lower · Passed
Voted Do Pass (H)
lower
Feb 9, 2026
Committee
Referred: Rules - Administrative(H)
lower
Jan 29, 2026
Lower · Passed
HCS Reported Do Pass (H) - AYES: 15 NOES: 0 PRESENT: 0
lower
Jan 29, 2026
Lower · Passed
HCS Voted Do Pass (H)
lower
Jan 20, 2026
Committee
Referred: Health and Mental Health(H)
lower
Jan 2, 2026
Introduced
Prefiled (H)
lower
1 primary · 2 co-sponsors

Sponsors