Healthcare (Insurance)

in committee · Pennsylvania · Senate Dec 29, 2025

SB 1126: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for epinephrine delivery systems.

SB 1126 requires most health insurance plans in Pennsylvania to cover at least two epinephrine delivery systems (such as EpiPens for severe allergic reactions) per year at a maximum annual cost of $35, regardless of the insured's deductible or other cost-sharing. This applies to individual and group health insurance policies, as well as certain nonprofit health plans. The Attorney General must investigate epinephrine drug pricing and submit a public report to the legislature within one year. The bill also allows plans to reduce cost-sharing below $35 and applies to high deductible and catastrophic health plans where permitted by federal law.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for epinephrine delivery systems at low cost, expanding access to critical allergy treatment and reducing patient financial barriers.95% confidence

Sub-Topics Insurance Prescription Drugs

Track

in committee · Pennsylvania · Senate Dec 22, 2025

SB 1122: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for menopause treatment coverage.

This bill (SB 1122) requires most health insurance policies sold in Pennsylvania to cover menopause treatment. Specifically, it mandates coverage for FDA-approved drugs, behavioral therapy, and post-hysterectomy menopause treatments under Section 635.11 of the Insurance Company Law. The requirement applies to standard health insurance policies (excluding dental, vision, workers' compensation, and similar limited-benefit plans) and takes effect 60 days after enactment, with most policies needing to comply within 180 days of the effective date. It does not alter existing cost-sharing rules like deductibles or copays.

Topics ✓ HealthcareSupports HealthcareBill mandates insurance coverage for menopause treatment, expanding health coverage and improving patient access to necessary care under Section 635.11.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · House Dec 9, 2025

HB 2096: An Act providing for direct primary care, medical service agreements and insurance, for medical service agreement requirements, for use of health savings accounts or flexible spending accounts and for use of other health care practitioners.

HB 2096 establishes a legal framework for direct primary care in Pennsylvania, allowing physicians to provide routine health services (like preventive care and chronic condition management) through written agreements with patients in exchange for a direct fee (e.g., monthly membership or retainer). These medical service agreements are explicitly exempt from state insurance regulations and must clearly state they do not provide comprehensive health insurance coverage. Patients may use health savings accounts or flexible spending accounts to pay for these agreements, subject to federal and state rules. The bill requires all agreements to be in writing, specify covered services and fees, allow termination with notice, and include the required disclaimer.

Topics ✓ HealthcareSupports HealthcareEstablishes legal framework for direct primary care, allowing fee-based routine services (preventive/chronic care) without insurance, potentially improving patient access to primary care.85% confidence

Sub-Topics Insurance Primary Care

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passed · Pennsylvania · House Dec 17, 2025

HR 382: A Resolution urging the Congress of the United States to retain expanded health insurance subsidies that enable consumers to purchase health insurance through Pennie.

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill urges extension of federal health insurance subsidies (a form of government spending/tax credit), directly supporting continued funding for essential health coverage and preventing premium increases that would impact state residents' fiscal b...95% confidence ✓ HealthcareSupports HealthcareUrges Congress to extend subsidies preventing 102% premium hikes and 150k coverage losses, directly protecting healthcare access and affordability.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill urges retention of health insurance subsidies, preventing 102% premium hikes and 150k coverage losses - directly supporting workers' access to affordable healthcare benefits, a core employment standard.95% confidence

Sub-Topics Insurance

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in committee · Pennsylvania · Senate Dec 5, 2025

SB 1112: An Act providing for access to contraceptives; imposing duties on the Insurance Department and the Department of Human Services; providing for severability; and imposing penalties.

SB 1112, the "Contraceptive Access for All Act," requires most health insurance plans in Pennsylvania - including Medicaid managed care plans and private health insurance - to cover all FDA-approved contraceptives without cost-sharing (like deductibles or copays). It specifically mandates coverage for prescription contraceptives, emergency contraception (like levonorgestrel), and over-the-counter oral contraceptives, and prohibits insurers from requiring prior authorization or step therapy for these items. The law applies to standard health insurance policies but excludes limited policies like dental, vision, or workers' compensation plans. It directly affects health insurers and managed care plans by requiring them to provide this coverage at no additional cost to enrollees.

Topics ✓ HealthcareSupports HealthcareMandates full insurance coverage for contraceptives without cost-sharing, expanding access to essential reproductive healthcare services per bill's explicit requirements.95% confidence

Sub-Topics Insurance Medicaid Women's Health

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in committee · Pennsylvania · House Aug 4, 2025

HB 1765: An Act amending Title 53 (Municipalities Generally) of the Pennsylvania Consolidated Statutes, in employees, providing for insurance benefits for part-time police officers.

HB 1765 would require Pennsylvania municipalities to provide insurance benefits to part-time police officers. The bill amends state law to extend existing insurance coverage provisions - currently applicable to full-time municipal employees - to include part-time police officers specifically. This change would directly affect part-time police officers and the local governments that employ them, mandating that municipalities include these benefits in their employment terms. The bill is currently under review by the Local Government committee.

Topics ✓ Budget & TaxesSupports Budget & TaxesMandates municipalities to fund insurance benefits for part-time police, increasing public safety spending requirements.80% confidence ✓ Criminal JusticeSupports Criminal JusticeExtends insurance benefits to part-time police officers, supporting law enforcement personnel welfare without direct reform impact.85% confidence ✓ HealthcareSupports HealthcareExtends health insurance coverage to part-time police officers, expanding access to healthcare benefits for municipal employees under existing insurance provisions.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentExtends mandatory insurance benefits to part-time police officers, expanding worker benefits under Labor & Employment policies95% confidence

Sub-Topics Policing Insurance

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in committee · Pennsylvania · House Apr 28, 2025

HB 1325: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for dental insurance medical loss ratios; and imposing penalties.

HB 1325 requires health insurers in Pennsylvania offering dental coverage to report annual "medical loss ratios" (MLRs) for dental policies. This means insurers must calculate the percentage of premium dollars spent directly on dental care (not administrative costs) and submit detailed reports by April 30 each year. The bill applies to all health insurers licensed in Pennsylvania that provide dental policies, whether standalone or bundled with medical coverage. Penalties may be imposed if insurers fail to comply with the reporting requirements or meet the MLR standards.

Topics ✓ HealthcareSupports HealthcareRequires dental insurers to report MLRs, ensuring more premium dollars fund care over admin costs, strengthening patient coverage and transparency in insurance.95% confidence

Sub-Topics Insurance

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signed · Pennsylvania · Senate Nov 24, 2025

SB 88: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, repealing provisions relating to coverage for mammographic examinations and breast imaging and providing for coverage for mammographic examinations, magnetic resonance imaging and other forms of breast imaging.

SB 88 amends Pennsylvania's Insurance Company Law to require health insurance plans sold in the state to cover specific breast imaging services without cost-sharing for policyholders. It mandates annual mammograms for women 40+ and physician-recommended mammograms for women under 40, plus MRI and other breast imaging for those at average or higher risk of breast cancer due to factors like family history, genetic mutations, or dense breast tissue. The law specifies coverage for screening, supplemental, and diagnostic exams but does not require coverage for mastectomies or override standard deductibles/copays beyond the minimum required services. This replaces prior requirements that allowed cost-sharing and excluded MRI coverage.

Topics ✓ HealthcareSupports HealthcareMandates no-cost coverage for breast imaging services including mammograms and MRIs, expanding preventive care access without cost-sharing for high-risk groups.95% confidence

Sub-Topics Insurance

passed · Pennsylvania · House Mar 25, 2025

HB 404: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, further providing for conditions subject to which policies are to be issued and for health insurance coverage for certain children of insured parents.

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.

Topics ✓ HealthcareSupports HealthcareExtends health coverage for children to age 26 (up from 19), prohibits coverage denials based on dependency factors, and allows up to age 29 in group plans.95% confidence

Sub-Topics Insurance

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signed · Pennsylvania · House Nov 12, 2025

HB 416: An Act amending the act of April 9, 1929 (P.L.343, No.176), known as The Fiscal Code, providing for Child Care Staff Recruitment and Retention Program; in 911 Emergency Communication Services, further providing for surcharge; in Department of Revenue, further providing for exclusion from classes of income and providing for research and experimental expenditures and qualified production property, for report to General Assembly and for interest expense; in joint underwriting association, further providing for findings and for definitions, repealing provisions relating to sunset and providing for risk-based capital certification, for fund transfers, for association oversight and additional duties, for Joint Underwriting Association Board, for board meetings, for construction, for dissolution, for appropriations and for reports and hearings; in State Health Insurance Exchange Affordability Program, further providing for Exchange Affordability Assistance Account; providing for Rural Health Transformation Program; in Treasury Department, providing for waiver of interest, costs and fees; in procedure for disbursement of money from the State Treasury, further providing for use and appropriation of unused Commonwealth funds; in oil and gas wells, further providing for Oil and Gas Lease Fund; providing for advanced air mobility sites and for public transportation vehicles; in human services, further providing for resident care and related costs; in Attorney General, providing for home improvement contractor registration fee; providing for Rare Disease Advisory Council, for affordable housing tax credit and for working Pennsylvanians tax credit; in additional keystone opportunity expansion zones, providing for additional keystone opportunity expansion zones for certain counties of the fourth class; providing for additional extensions of keystone opportunity zones; in special funds, further providing for funding, for expiration and for other grants; in additional special funds and restricted accounts, further providing for establishment of special fund and account, for use of fund and for distributions from Pennsylvania Race Horse Development Fund and providing for refund of 2003 assessment by Insurance Department; in additional special funds and restricted accounts relating to Service and Infrastructure Improvement Fund, further providing for deposits and providing for Property Tax Relief Fund; in general budget implementation, further providing Executive Offices, for Department of Community and Economic Development, for Department of Environmental Protection, for Pennsylvania Fish and Boat Commission, for Pennsylvania Higher Education Assistance Agency and for Commonwealth Financing Authority, providing for stenography services, further providing for surcharges, for Federal and Commonwealth use of forest land and for Multimodal Transportation Fund and providing for State Sexual Offenders Assessment Board, for interest transfers, for fund transfers and for miscellaneous provisions; in 2024-2025 budget implementation, further providing for Department of Education, for Department of Environmental Protection and for Department of Human Services; in Streamlining Permits for Economic Expansion and Development Program, further providing for scope of article, for definitions and for the Streamlining Permits for Economic Expansion and Development Program, providing for review and determination of specific permits and for State agency permits and further providing for construction; providing for electricity load forecast accountability, for 2025-2026 budget implementation and for 2025-2026 restrictions on appropriations for funds and accounts; making repeals; and making editorial changes.

HB 416 establishes a new Child Care Staff Recruitment and Retention Program to support early childhood educators and creates a Rural Health Transformation Program to improve healthcare access in underserved areas. It also streamlines permit processes for economic development projects through the Streamlining Permits for Economic Expansion and Development Program. These provisions are integrated into the 2025 state budget implementation, alongside administrative updates to tax collection procedures, state fund management, and reporting requirements for agencies like the Department of Revenue and Treasury. The bill does not alter existing tax rates or create new funding streams but modifies how current state financial systems operate.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill funds essential programs (Child Care, Rural Health) and provides tax credits (affordable housing, working Pennsylvanians), supporting budget allocation and tax relief.90% confidence ✓ HealthcareSupports HealthcareBill establishes Rural Health Transformation Program to improve healthcare access in underserved areas, directly advancing healthcare services and access.90% confidence ✓ HousingSupports HousingBill explicitly includes 'affordable housing tax credit' as a direct funding mechanism for affordable housing programs.95% confidence ✓ TransportationSupports TransportationBill explicitly mentions 'public transportation vehicles' and 'advanced air mobility sites' in title, directly supporting transportation infrastructure expansion.90% confidence

Sub-Topics Fees & Licensing Property Tax State Budget Insurance Substance Abuse Affordable Housing Property Development Property Taxes Vehicle Registration