HB 2099

86(R) - 2019
House Insurance
House Insurance

Vote Recommendation

  • Neutral
  • Neutral
  • Neutral
  • Negative
  • Neutral


Stan Lambert
Eddie Lucio III
Tom Oliverson
J.D. Sheffield
John Zerwas


Steve Allison
Trent Ashby
Ernest Bailes
Dwayne Bohac
Greg Bonnen
Rhetta Andrews Bowers
Brad Buckley
Giovanni Capriglione
Travis Clardy
Sheryl Cole
Philip Cortez
Drew Darby
Jay Dean
Alex Dominguez
Barbara Gervin-Hawkins
Jessica Gonzalez
Mary Gonzalez
Bobby Guerra
Cody Harris
Todd Hunter
Julie Johnson
Kyle Kacal
Ken King
Armando Martinez
Rick Miller
Ina Minjarez
Evelina Ortega
Leo Pacheco
Four Price
John Raney
Richard Raymond
Toni Rose
Jon E. Rosenthal
Carl Sherman
Hugh Shine
Phil Stephenson
Lynn Stucky
Hubert Vo
James White
John Wray


Donna Campbell

Bill Caption

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

Fiscal Notes

No significant fiscal implication to the State is anticipated.

Bill Analysis

HB 2099 would require the required notice provided by a health benefit plan issuer that modifies drug coverage under the plan to include a statement indicating that the issuer is modifying drug coverage, explaining the type of modification, and indicating that, on renewal of the plan, the issuer may not modify an enrollee's contracted benefit level for any prescription drug that was approved or covered under the previous plan year as provided by these bill provisions.

The bill would also include the increase of an out-of-pocket expense that an enrollee must pay for a drug and the reduction of the maximum drug coverage amount among the modifications that require such notice, and would remove the condition that the movement of a drug to a higher cost-sharing tier only requires notice if a general drug alternative is not available. Modifications favorable to enrollees would not require notice.

HB 2099 would also prohibit a health benefit plan issuer, on renewal of a plan, from modifying an enrollee's contracted benefit level for any prescription drug that was approved or covered under the plan in the immediately preceding plan year, and prescribed during that year for a medical condition or mental illness if: (1) the enrollee was covered by the plan on the date immediately preceding the renewal date; (2) a physician determines that the drug is the most appropriate course of treatment; and (3) a physician prescribes the drug the the medical condition or mental illness. Prohibited modifications would include removing a drug from a formulary, adding a prior authorization requirement, imposing a quantity limit for a drug, and moving a drug to a higher cost-sharing tier, among other things.

Vote Recommendation Notes

Texas Action recommends opposing this bill as a violation of limited our government principle. This bill would allow additional, undue governmental interference in the healthcare industry by prohibiting health benefit plan issuers from modifying contract terms related to certain prescription drugs upon policy renewal in order to reflect market changes. This effectively puts in place artificial price controls which prohibit insurers from adjusting prices based on market conditions.