HB 282 amends Pennsylvania's Human Services Code (1967) to clarify eligibility rules for individuals receiving medical assistance under public assistance programs. The bill directly affects current and prospective recipients of medical assistance, ensuring consistent application of qualification standards. Key provisions update how eligibility is determined for medical assistance, though specific changes are not detailed in the provided context. The bill passed the House on June 3, 2025, and was referred to the Health & Human Services committee for further review.
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 618, the Health Insurance Access Protection Act, prohibits health insurers from denying coverage or charging higher premiums based on a person's health condition, including preexisting conditions. This law applies to both individual and group health insurance policies, protecting enrollees and their dependents from discrimination in enrollment or pricing. The Insurance Department and Commissioner are tasked with enforcing these rules, and the bill includes penalties for insurers that violate the prohibitions.
HB 755 requires health insurers in Pennsylvania (excluding grandfathered plans) to cover all preventive health services listed by the Insurance Department without cost-sharing, such as copays or deductibles. This directly affects insurers who must comply with the coverage rules and enrollees who gain access to preventive care like vaccinations and screenings at no extra cost. The bill empowers the Insurance Department to create and update the preventive services list through a public comment process (15+ business days) and enforce compliance with penalties for violations. It aligns with federal preventive care standards but allows Pennsylvania to adjust the list based on public input and evidence-based guidelines.
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.
HB 111 prohibits life insurance companies in Pennsylvania from denying coverage, limiting benefits, or charging higher rates to applicants or policyholders solely because they have been prescribed an opioid overdose reversal agent (like naloxone). The bill directly affects individuals who use these medications, including those with opioid use disorder or at risk of overdose. It defines "adverse action" to include these discriminatory practices and makes such actions violations of existing laws against unfair insurance practices. The law takes effect 60 days after enactment.
HB 190 requires Pennsylvania schools to annually provide eating disorder awareness and education materials to parents, guardians, and key school staff (like counselors and principals) for students in grades 6-12. The bill mandates that schools share this information via email, mail, or website, using materials developed by the Department of Health in collaboration with an advisory committee of experts from groups like the National Alliance for Eating Disorders and school health organizations. These materials must explain warning signs, resources, prevention, and be available in multiple languages. The law directly affects all public, charter, cyber, and nonpublic schools in Pennsylvania, aiming to improve early recognition and support for students facing eating disorders.
