June 24, 2026 · INSURANCE · 3,294 words · 10 speakers · 48 segments
It's 12 o'clock. I would like to call this standing room only meeting of the House Insurance Committee to order. Heather, please take the roll.
Chairman Warren. Here. Abney. Designation. Brennan. Designation. Cephas. Designation. Paddock. Here. Kosarowski. Designation. Malagary. Here. Mirsky. Designation. Mullins. Designation. Monroe. Designation. Parker. Here. Sappy. Here. Scott. Here. Venkat. Here. Chairwoman Pickett. Here. Bernstein. Designation. Flood. Here. Fritz. Here. Greiner. Here. Kutz. Here. Ledbetter. Here. Menser. Here. Nelson. Here. Olsamer. Here. Watrow. Zimmerman. Here.
We have a quorum. Great. Thank you, Heather. The first order of business is consideration of House Bill 2226. Samantha, please explain the bill.
House Bill 2226 would define a copay accumulator policy as an unfair, deceptive act or practice.
And, Samantha, there's one amendment, which I offer as Amendment A03890. Would you please explain the amendment?
Amendment A03890 would gut and replace the original bill and place the language within Title 40 of the Pennsylvania Consolidated Statute. The amendment would require that for each fill of a prescription drug, a prescription drug coverage administrator must reduce the cost sharing incurred by a covered person or apply any amounts paid on behalf of a covered person toward the covered person's in-network, out-of-pocket maximum, and other cost sharing requirements. Additionally, this amendment would allow for a prescription drug administrator to be exempt from the requirements of this chapter if entered into a qualifying agreement with an entity that provides drug manufacturer direct support, or if the administrator offers a voluntary program through which the value of a pharmaceutical manufacturer's assistance program is applied to reduce a person's out-of-pocket costs to a fixed monthly amount for the benefit year for a specific prescription. Thank you.
Are there any negative votes on the amendment?
Thank you, Mr. Chairman. We don't have any comments on the amendment, but the Republicans will be a no.
Okay. Shall we take a roll call or shall we? All Democrats vote yes, either in person or by designation on the amendment. So, Amendment A03890. Yeah, it is. It is adopted. So the question is, will the committee report the bill as amended? And we have the prime sponsor, Representative Kincaid. There we are. Representative Kincaid, would you like to say a few words on the bill as amended?
Thank you, Mr. Chairman. I appreciate the amendment that was offered. This has been a bit of a painstaking process in trying to get this bill to a place in the insurance law. I think there may be some tweaks still to be made, but I think that moving this forward right now advances a conversation that we need to be having when we're talking about drug affordability. So I appreciate the committee's consideration on this bill. So thank you.
Thank you, Representative Kim. Kade, Madam Chair, any comments on the bill?
Thank you, Mr. Chairman. We don't have any comments on the bill, but the Republicans will be no.
Is there any other discussion on the bill? So hearing none, shall we take the vote? I understand all Democrats will vote yes, all Republicans will vote no, and the bill passes by a vote of 14 to 12. Thank you. The next order of business is consideration of House Bill 2652. Samantha, please explain this bill.
House Bill 2652 requires a health benefit plan, health insurer, or pharmacy benefits manager to credit toward a covered person's in-network, out-of-pocket maximum, and other cost-sharing requirements incurred by a covered person by directly purchasing a prescription from a pharmacy or through a discount drug purchasing entity.
And there's one amendment to this bill, which I will offer as Amendment A03875. Samantha, please explain the amendment.
Amendment A03875 would require a prescription drug coverage administrator that no longer qualifies for an exemption to come into compliance with the chapter within 60 days of failing to meet the requirements for the exemption. The 60-day period may be extended at the insurance commissioner's discretion.
Madam Chair, any comments?
Thank you again, Mr. Chairman. We don't have any comments, but Republicans will not oppose the amendment.
So there being no negative votes, all Democrats vote yes on the amendment. There being no negative votes on the amendment, the amendment A03875 is adopted unanimously. The question then is, will the committee report the bill as amended? Oh. Apparently I've got to talk closer to the mic. Hearing no negative votes on the amendment, Amendment A03875 is adopted unanimously. The question then is, will the committee report the bill as amended?
And we have a return visit by Representative Kingade the sponsor of the bill Thank you Mr Chairman This bill is similar but not the same to my previous legislation We taking on prescription affordability in two different ways This would basically require that if somebody is able to find a cheaper price for a prescription, whether it's through an independent pharmacy or, you know, TrumpRx or, you know, Cost Plus, that the money that they would spend on that prescription would have to be counted towards the out-of-pocket maximum for an insurance under their insurance plan. So this helps people to be able to make their own decisions about, you know, the prescriptions that they're purchasing and shop around and actually be able to purchase the medications at the best cost for them, while also requiring that insurance companies recognize that they are still spending money out-of-pocket on their medications and count that towards the underlying out-of-pocket maximum. So in this way, we're, again, trying to just bring down the cost of accessing medication, necessary medication, by bringing independent pharmacies and independent purchasing together with a person's insurance. So thank you. I would appreciate an affirmative vote.
Thank you, Representative Kincaid. Any comments on this bill, Madam Chair?
I thank you, Mr. Chairman. We are told the bill will save consumers money when they need a prescription. Well, I'm not convinced. Consumers won't get reimbursed for online purchases. Consumers won't be able to buy a GLP-1 and submit a claim. Consumers will certainly be confused if a claim is denied because their insurer has an exemption. If enacted, constituents will be calling us and asking what we really did. I'm concerned about the impact on those independent pharmacies. More than 1,000 pharmacies have closed since 2020. Pharmacists have stated legislation like this will create more pharmacy deserts. They also believe the use of online platforms increases the risk of improper use of medication and uncoordinated care, and especially for chronic conditions. I agree with their thoughts. It is for these reasons and more I will be voting no, and I will ask for a negative vote. Thank you, Mr. Chairman.
Thank you, Chair Pickett. Any comments from any other members of the committee? on the bill? Seeing none, are there negative votes on the bill? All Republicans will be a no. Are there any Democratic negative votes on the bill? All Democrats having voted yes, the vote is 14 to 12. The bill passes and shall be reported. Thank you, Representative Kengate. Congratulations on your double victory. The next order of business is consideration of House Bill 2653. Samantha, please explain the bill.
House Bill 2653 prohibits an insurer from refusing to contract with a behavioral health care provider that agrees to accept the insurer's contract terms and conditions. And the prime sponsor of this bill, Representative Sappy, is a member of the committee and here with us today. Representative Sappy, would you care to speak on the bill?
Yes, thank you, Chairman. We all know that there's a mental health crisis in Pennsylvania, and people are struggling to access life-saving care. And in particular concern for me is our young people in Pennsylvania. Too often, our constituents are forced to seek out-of-network care because they can't find in-network care without a long wait list, or even worse, they're going without care. With that being said, House Bill 2653 helps Pennsylvania families by requiring health insurers to accept any willing behavioral health care provider into their network so long as the provider agrees to the insurer's existing terms and conditions. This is a straightforward policy solution that brings transparency to insurance company network practices, and I ask for an affirmative vote.
Thank you, Representative Sapi. We have a list here of proposed speakers on the bill. First, I'll move to report House Bill 2653 as committed. Representative Mentzer, is he there to speak on the bill?
Yes, thank you, Chairman Warren. While I understand this bill's trying to address access to behavioral health providers, when I hear from providers that want to join an insurance network and can't, the issue usually is a hangup in the credentialing process. The bill that I introduced, House Bill 544, would establish credentialing timelines so providers can quickly join networks, see patients, and bill insurance. I believe this will better address the delays and challenges we see with network access. I'd encourage the majority to take a closer look at this bipartisan bill. Thank you, Mr. Chairman.
Thank you, Representative Metzer. Representative Nelson, would you care to speak on the bill?
Thank you, Mr. Chair. Looks like I'm coming across. Am I close enough on this mic? I do appreciate and share the desire to try to shorten access so that people in need can get the care they're looking for. But when I reached out to both my county and providers in the area, they shared a lot of concerns because there's a distinct difference between access versus quality care. And the RFP process, network providers, unfortunately, there's a reality that some providers are not as good as others. And in specialty areas specifically conversations about sex offender treatment about foster care treatment a space that is helping children that have experienced trauma not all providers are the same And individuals have concern that if everyone is automatically approved we will create a situation of low-quality care. We'll eliminate the ability for counties and networks to be able to differentiate between low-quality providers and ones that are going to meet the need in the very sensitive areas. And so I share the desire to shorten the timeline for treatment, but I have to recommend opposing this bill for the very people that it's intending to help. We have to ensure that low-quality providers are not given access to these very sensitive areas. Thank you, Mr. Chair.
Thank you, Representative Nelson. Representative Venkot, would you like to speak on the bill?
Thank you, Chair Warren, and I appreciate Representative Sappy bringing this legislation forward. Certainly, as a practicing physician, I understand the frustrations that exist in negotiations between clinicians and insurance companies on network participation, and it is a concern in behavioral health in terms of access to care. Frankly, as an emergency physician, I think that the network access piece doesn't make a lot of sense when we talk about certain categories of care, like EMTALA-related care, where, frankly, emergency departments are providing a large amount of behavioral health care, not by choice, but by necessity. However, from a legislative perspective, I have grave concerns about this bill. essentially we rely for better or for worse on insurance companies for the limited amounts of cost containment that we have within the health insurance system. And in any willing provider mandate as drafted in this legislation would essentially open the floodgates and mean that any limitations to cost containment within the healthcare system, there will be a precedent for doing away with those. And I think that's something that we as a committee and as a General Assembly should look at very skeptically. I also think that this proposal is looking for an easy answer to what is a very complex solution, that in behavioral health, most insurance companies in the Commonwealth have an open network policy. So I'm not sure that this legislation is going to advance that. However, most health care providers who provide mental health services are not participating because reimbursement rates are extraordinarily low. And that is an issue that if we don't address as a General Assembly, we will not find that this legislation is a solution. Lastly, and I say this cautiously, but I think it has to be acknowledged, there is a significant issue with waste, fraud, and abuse in the mental health billing and coding space. It has been well reported and is something that we need to take into account. I do think that this legislation deserves further consideration. I hope that it will change to look at issues related to network adequacy and related to reimbursement. reimbursement. I will vote to advance it out of committee, but in its current form, I do not think that it is ready for consideration and legislative enactment. And I would caution us in that deliberative process to look at amendments as we move on to floor action.
Thank you, Representative Van Kopp. Before Chair Pickett speaks, are there any other members of the committee who would like to speak on the bill?
Madam Chair? Thank you, Mr. Chairman. I was in the restaurant business prior to being elected. I had applicants that were willing to take a job under my terms, but I had the freedom to decide if I wanted to enter into a business relationship with them. Under this bill, the heavy hand of government would be telling a business that they must contract with another party, like it or not. I'm not sure that's the direction we want to go. I've been the Republican chair for many years, and I cannot recall a behavioral health provider telling me about a closed insurance network. We need more mental health providers. That's clear. All the more reason to encourage young people to enter this field as it continues to grow. That is a way to reduce wait times and increase access to services. I'll be a no on the vote, and I ask for a negative vote, and I do thank you, Mr. Chairman.
Thank you, Chair. Are there any negative? I think I know the answer to this. Are there any negative votes on the bill? Republicans are a no, or do any Democratic members vote no on the bill? Hearing none, the bill passes by a vote of 14 to 12. Thank you. Congratulations, Representative Sappy. Next up, our next order of business is a consideration of Senate Bill 1210. Samantha, please explain this bill.
Senate Bill 1210 would codify the insurance commissioner's authority over pre-licensure education courses for insurance agents.
Thank you. I move to report Senate Bill 1210 as committed. Any comments on this bill, Madam Chair?
Thank you. And as mentioned, the bill fixes an issue with pre-licensed education courses provided by trade associations, and Republicans will be a yes.
Any further discussion on the bill? Seeing none, are there any negative votes on the bill? Seeing and hearing none, Senate Bill 1210 is reported from the House Insurance Committee unanimously. We'll now proceed to the any other business before the committee. The chair calls up House Bill 2649. And I'll say here, this bill as well as some of the others, much of the final work was done this week by our staff, the House Insurance Committee staff both my staff and Representative Pickett staff and by representatives of the Pennsylvania Insurance Department and also by the staffs of the representatives and Senator in that case who have introduced the bill. So thank you very much for your work during this budget time in expediting the consideration and drafting and finalization of these bills. With that said, Samantha, please explain House Bill 2649.
House Bill 2649 would require insurers to provide coverage for fertility preservation services if a medically necessary treatment may directly or indirectly cause iatrogenic infertility in the covered person.
Thank you. And the co-prime sponsor, Representative Marcel, my colleague from Bucks County, is here with us today.
Representative Marcel, would you like to say a few words? Thank you very much to Chairs Warren and Pickett for bringing up this bill today. First, I would like to thank my co-prime sponsors for this legislation, Representative Kosarowski and Representative Mays, for their partnership on House Bill 2649. For many Pennsylvanians diagnosed with cancer, the focus is understandably on survival. Thanks to access advances in treatment, more patients are beating cancer than ever before. However, treatments such as chemotherapy, radiation, and surgery can also result in permanent infertility. For patients who hope to have children in the future, fertility preservation can provide that opportunity. Unfortunately, the decisions to preserve fertility must often be made within a matter of days before treatment begins. And these services can cost thousands of dollars and are often not covered by insurance. With a short window, there is simply no time to fundraise, apply for a loan, or fight insurance denials. This is not a question of medical science, but rather one of meaningful access. House Bill 2649 is based on established medical practice and would require insurance coverage for standard fertility preservation services and storage for cancer patients undergoing medically necessary treatments with a high likelihood of infertility. Surviving cancer should not mean losing the opportunity to start or grow a family. This bill helps to remove a significant financial barrier at an already very difficult time in a patient's life. Pennsylvania has the chance to join 21 other states in passing this bipartisan pro-family initiative, and I respectfully ask everyone for an affirmative vote. Thank you very much.
Thank you, Representative Marcel. I move to report House Bill 2649 as committed. Any comments, Madam Chair?
Thank you, Mr. Chairman. Well, I'm disappointed in the process of calling up this bill the way it's been done, But Republicans will not oppose the bill in committee. Thank you.
Is there any further discussion of the bill? Are there any negative votes on the bill? Hearing none, House Bill 2649 is reported from the House Insurance Committee unanimously. Thank you, Representative Marcel. Congratulations. The next items on our agenda, which we added yesterday on notice to the members, is I would like to move the package, if that's okay, Representative or Chair Pickett. It is. I move to re-refer House Bill 1244 and House Bill 1346, both introduced by Representative Hambidge, and House Bill 1827 and House Bill 2545, both introduced by Representative Schusterman, from the Insurance Committee to the House Aging and Older Adult Services Committee.
Samantha, would you please explain the bills? House Bill 1244 would require insurers to provide coverage for the diagnosis and treatment of pelvic floor dysfunction. House Bill 1346 would require insurers to provide coverage for hormonal and non-hormonal treatments for the management of menopausal symptoms. House Bill 1827 would require insurers to provide coverage for preventive measures, testing, and treatment for osteoporosis for individuals who have reached menopause. And House Bill 2545 would require insurers to provide coverage for vaginal estrogen for the treatment of menopausal symptoms and for the prevention of urinary tract infections.
Thank you, Samantha. There seems to be a three-part process here. So first, I ask the members to support the motion to re-refer. Any comments, Madam Chair?
No comments, Mr. Chairman.
And is there any discussion on the motion to re-refer? Seeing none, are there any negative votes on the motion to re-refer? House Bills 1244, House Bill 1346, House Bill 1827, and House Bill 2545 to the Aging and Older Adult Services Committee. Hearing none, House Bill 1244, House Bill 1346, House Bill 1827, and House Bill 2545 are unanimously referred to the House Aging and Older Adult Services Committee. There being no further business, thank you all. This meeting is adjourned. Thank you.