NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A128A
SPONSOR: Gonzalez-Rojas TITLE OF BILL:
An act to amend the insurance law, in relation to requiring coverage of
certain asthma inhalers at no cost
PURPOSE OR GENERAL IDEA OF BILL:
Requires insurance coverage for inhalers at no cost
SUMMARY OF PROVISIONS:
Section 1 amends Section 3216 subsection (i) of the insurance law to
require that every insurance policy shall include coverage for inhalers
for the treatment of asthma. The section also requires that coverage for
one form of rescue inhaler and one form of maintenance inhaler shall not
be subject to a deductible, copayment, coinsurance or any other cost-
sharing requirement.
Section 2 amends Section 3221 subsection (1) of the insurance law to
require that ever health insurance policy require coverage for inhalers
for the treatment of asthma and that coverage for one form of rescue
inhaler and one form of maintenance inhaler shall not be subject to a
deductible, copayment, coinsurance or any other cost-sharing require-
ment.
Section 3 amends Section 4303 of the insurance law to add a new
subsection to require a medical expense indemnity corporation or health
service corporation to include coverage for inhalers for the treatment
of asthma coverage for one form of rescue inhaler and one form of main-
tenance inhaler shall not be subject to a deductible, copayment, coinsu-
rance or any other cost-sharing requirement.
Section 4 sets the effective date.
JUSTIFICATION:
According to the U.S Food and Drug Administration in 2022 more than 20
million adults and over 4.5 million children were living with asthma.
But this reality has done nothing to reduce the cost of asthma inhalers
with the price of each life-saving device being as high as $640 a month
in some instances. U.S Senator Bernie Sanders wrote to manufacturers
stating that the prices force patients, especially the uninsured and
underinsured, to ration doses or abandon their prescriptions altogether.
The results are predictable and devastating. Without consistent access
to inhalers, people with asthma and COPD are more likely to get sick, to
be hospitalized, and to die.
The U.S Centers for Disease Control has found that asthma kills about 10
people every day, while chronic obstructive pulmonary disease (COPD)
kills about 390 people every day and is the sixth-leading cause of death
in the United States. Asthma and COPD also place a strain on our health-
care system. Per the CDC, each year, asthma is responsible for more than
1.7 million emergency department visits and over $50 billion in health-
care costs.
Recently, manufacturers AstraZeneca, Boebringer Ingelheim, and GlaxoS-
mithKline committed to capping the out-of-pocket cost at $35 a month.
This bill will require no cost for inhalers in New York State so we can
treat asthma and save lives.
LEGISLATIVE HISTORY:
2024: Introduced and reported to Insurance Committee
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined.
EFFECTIVE DATE:
This act shall take effect on January 1, 2027 and shall apply to all
policies and contracts issued, renewed, modified, altered, or amended on
or after such date.
