This Pennsylvania House resolution (HR 382) urges Congress to extend expanded health insurance subsidies that currently help Pennsylvanians purchase coverage through Pennie, the state's health insurance marketplace. Without extension, these subsidies expire December 31, 2025, causing average premium increases of 102% for Pennie customers - projected to push 150,000 people to lose coverage. The resolution highlights that without the expanded credits, a couple earning $85,000 annually would pay $25,776 yearly for insurance (31% of their income), compared to lower costs under current subsidies. It cites Pennie's 2025 enrollment of nearly 500,000 customers and a 16% drop in new sign-ups since Open Enrollment 2026 as evidence of the need for continued support. The resolution has no legal force but requests congressional action to maintain affordability.
HB 1828 requires health insurance plans in Pennsylvania to cover all recommended vaccines without requiring patients to pay out-of-pocket costs like copays or deductibles. It directly affects insurance companies by mandating this coverage and patients who rely on insurance for routine immunizations (e.g., childhood vaccines, flu shots). The bill adds penalties for insurers that fail to comply with the coverage requirement. This policy change ensures broader access to vaccines by removing financial barriers under insurance plans.
HB 1234 amends Pennsylvania's Human Services Code to require public assistance programs to cover the cost of blood pressure monitors for eligible recipients. This change directly affects individuals enrolled in state public assistance programs who need blood pressure monitoring for health management. The bill adds blood pressure monitors to the list of covered medical equipment under the public assistance program, ensuring these devices are provided without cost to recipients. It does not change eligibility requirements but expands existing coverage to include this specific monitoring tool. The bill passed final passage on July 1, 2025, and was referred to the Health & Human Services committee.
SB 95 amends Pennsylvania's Pharmacy Act to create a 180-day provisional license for pharmacists moving from other states, allowing them to practice without demonstrating competency under Pennsylvania's requirements. It also permits emergency medical services providers to distribute naloxone dose packages for opioid overdose reversal under specific conditions, including a Department of Health standing order and voluntary distribution without liability. Additionally, the bill requires pharmacies to disclose prescription drug prices (brand vs. generic), cost-sharing amounts, and health insurance options upon customer request. These changes aim to improve pharmacist mobility, expand naloxone access, and increase price transparency for consumers.
HB 1100 amends Pennsylvania's Human Services Code to allow public assistance recipients to use their benefits to purchase diapers and menstrual hygiene products through a new waiver program. This directly affects low-income individuals and families enrolled in public assistance programs who currently cannot use their benefits for these essential items. The key provision adds diapers and menstrual hygiene products to the list of eligible purchases under an administrative waiver, changing the existing code to expand access to basic necessities. The bill does not change benefit amounts or eligibility criteria but creates a new pathway for purchasing specific hygiene products. It passed the legislature in June 2025 and was referred to the Health & Human Services committee for implementation.
HB 1445 requires health insurers in Pennsylvania to cover medically necessary health services provided in schools - such as mental health care, behavioral health services, and speech therapy - without denying coverage solely because the service occurs in a school setting. It prohibits insurers from excluding coverage based on location (e.g., through "school setting" or "place of service" exclusions), applying to public, charter, cyber charter, and private schools. Exceptions allow denials if services are provided by unlicensed individuals, are not medically necessary per insurer policies, or conflict with existing legal obligations (like IEPs). This law directly affects students receiving school-based care, insurers, and school entities, ensuring coverage parity for services delivered on school premises.
HB 1140 requires health insurers and Medicaid/CHIP managed care plans in Pennsylvania to cover all FDA-approved contraceptives - including prescription drugs, devices, emergency contraception (like levonorgestrel), and oral contraceptives - without any out-of-pocket costs for enrollees. It specifically prohibits prior authorization or step therapy for emergency and oral contraceptives, and mandates coverage for sterilization procedures and related services like counseling. The bill directly affects health insurers, managed care plans, and their enrollees by expanding contraceptive coverage under state insurance regulations. It exempts male condoms from coverage requirements but ensures no cost-sharing for covered contraceptive methods.
HB 535 bans Pennsylvania health insurers from setting annual or lifetime dollar limits on core health benefits for enrollees, whether services are provided by in-network or out-of-network providers. It applies to all individual and group health insurance policies (excluding specific types like Medicare supplements or dental/vision-only plans) and prohibits limits on benefits that were already covered without such caps in 2025 policies. The Insurance Department can enforce this through fines up to $5,000 per violation (or $10,000 for willful violations), with annual caps of $500,000 for insurers. The law does not require coverage of specific benefits but eliminates existing dollar limit practices for covered services.
HB 404 amends Pennsylvania's Insurance Company Law to extend health insurance coverage for children under family policies. It requires policies to cover dependent children up to age 26 (previously 19) and prohibits insurers from denying or restricting coverage based on a child's financial dependency, residency, marital status, school enrollment, or employment. The bill also allows group health plans to extend coverage for adult children up to age 29 if they meet specific conditions, such as not being married, having no dependents, and residing in Pennsylvania or attending school full-time. This affects all health insurance policies sold in Pennsylvania that provide dependent child coverage.
