AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HEALTH AND HUMAN SERVICES.

House of Representatives
sHB5040 / File No. 403 1

General Assembly File No. 403
February Session, 2026 Substitute House Bill No. 5040

House of Representatives, April 7, 2026

The Committee on Human Services reported through REP.
GILCHREST of the 18th Dist., Chairperson of the Committee on
the part of the House, that the substitute bill ought to pass.

AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET
RECOMMENDATIONS FOR HEALTH AND HUMAN SERVICES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsection (b) of section 17b-191 of the 2026 supplement to 1
the general statutes is repealed and the following is substituted in lieu 2
thereof (Effective July 1, 2026): 3
(b) The state-administered general assistance program shall provide 4
cash assistance of [(1)] two hundred sixty-nine dollars per month [for an 5
unemployable person upon determination of such person's 6
unemployability; (2) two hundred dollars per month for a transitional 7
person who is required to pay for shelter; and (3) fifty dollars per month 8
for a transitional person who is not required to pay for shelter ] to 9
persons eligible for the program . The standard of assistance paid for 10
individuals residing in rated boarding facilities shall remain at the level 11
in effect on August 31, 2003. No person shall be eligible for cash 12
assistance under the program if eligible for cash assistance under any 13
other state or federal cash assistance program. The standards of 14
sHB5040 File No. 403

sHB5040 / File No. 403 2

assistance set forth in this subsection shall be subject to annual increases, 15
as described in subsection (b) of section 17b-104. 16
Sec. 2. Subsection (f) of section 17b -274d of the general statutes is 17
repealed and the following is substituted in lieu thereof (Effective July 1, 18
2026): 19
(f) Nonpreferred drugs in the classes of drugs included on the 20
preferred drug lists shall be subject to prior authorization. Prior 21
authorization is not required for any mental -health-related drug that 22
has been filled or refilled, in any dosage, at least one time in the one -23
year period prior to the date the individual presents a prescription for 24
the drug at a pharmacy. If prior authorization is granted for a drug not 25
included on a preferred drug list, the authorization shall be valid for one 26
year from the date the prescription is first filled. [Antiretroviral classes 27
of drugs shall not be included on the preferred drug lists.] 28
Sec. 3. (NEW) ( Effective July 1, 2026 ) (a) The Commissioner of Social 29
Services may periodically review available data on the clinical 30
effectiveness of outpatient prescription drugs covered under the 31
Medicaid program that are projected to exceed (1) a net cost per 32
consumer, after factoring in rebates, of twenty-five thousand dollars per 33
year, or (2) an annual aggregate cost, after factoring in rebates to the 34
medical assistance program, of ten million dollars. The commissioner 35
may, within available appropriations, contract with a third party to 36
conduct a comparative effectiveness review of any such outpatient 37
prescription drug. For purposes of this section, "rebate" means an 38
amount sent to the state by a prescription drug manufacturer to offset 39
the cost of outpatient prescription drugs covered by the Medicaid 40
program. 41
(b) Any such comparative effectiveness review shall include, but 42
need not be limited to: (1) Clinical efficacy and outcomes; (2) 43
information relating to the pricing of the outpatient prescription drug, 44
including, but not limited to, information relating to prices paid by other 45
states or developed nations; (3) such drug's net price to the Medicaid 46
program as compared to its therapeutic benefits, including, but not 47
sHB5040 File No. 403

sHB5040 / File No. 403 3

limited to, the seriousness and prevalence of the disease or condition 48
that is treated by the drug; (4) the extent of utilization of such drug; (5) 49
the likelihood that the use of such drug will reduce the need for other 50
medical care; (6) the number of manufacturers that produce such drug; 51
and (7) whether there are pharmaceutical equivalents of such drug. 52
(c) The Commissioner of Social Service may make public and share 53
the results of any comparative effectiveness review with any entity, 54
including any multistate prescription drug purchasing collaborative in 55
which the state is a participating member, in order to negotiate 56
additional supplemental rebate agreements beyond any rebates 57
required under federal law. 58
This act shall take effect as follows and shall amend the following
sections:

Section 1 July 1, 2026 17b-191(b)
Sec. 2 July 1, 2026 17b-274d(f)
Sec. 3 July 1, 2026 New section

Statement of Legislative Commissioners:
In Section 3(a)(2) and 3(b), references to "prescription drugs" were
changed to "outpatient prescription drugs" or "such drug" for
consistency, and the provisions of Section 3(c) were rewritten for clarity.

HS Joint Favorable Subst.

sHB5040 File No. 403

sHB5040 / File No. 403 4

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of
the General Assembly, solely for purposes of information, summarization and explanation and do not
represent the intent of the General Assembly or either chamber thereof for any purpose. In general,
fiscal impacts are based upon a variety of informational sources, including the analyst’s professional
knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final
products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:
Agency Affected Fund-Effect FY 27 $ FY 28 $
Social Services, Dept. GF - Net Savings (894,000) (1,142,000)
Note: GF=General Fund
Municipal Impact: None
Explanation
The bill results in net savings to the Department of Social Services of
$894,000 in FY 27 and $1,142,000 in FY 28.
Section 1 results in a cost of $56,000 in FY 27 and $58,000 in FY 28
associated with eliminating a reduced monthly benefit for transitional
individuals under the State Administered General Assistance (SAGA)
program.
Section 2 results in state Medicaid savings of $950,000 in FY 27 and
$1.2 million in FY 28 due to adding antiretroviral drugs to the Preferred
Drug List (PDL), resulting in savings associated with supplemental
rebates.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to service utilization and supplemental
rebates.

sHB5040 File No. 403

sHB5040 / File No. 403 5

OLR Bill Analysis
sHB 5040

AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET
RECOMMENDATIONS FOR HEALTH AND HUMAN SERVICES.

SUMMARY
This bill makes various unrelated changes to human services-related
statutes. Specifically, the bill:
1. sets a standardized $269 monthly cash benefit for State
Administered General Assistance (SAGA) beneficiaries, thereby
eliminating current law’s payment reduction for certain
transitional people (§ 1);
2. adds antiretroviral drugs to the Medicaid preferred drug lists,
allowing the state to negotiate supplemental rebates with drug
manufacturers for these drugs (§ 2); and
3. authorizes the Department of Social Services (DSS) commissioner
to periodically review available data on the clinical effectiveness
of certain Medicaid-covered outpatient prescription drugs (§ 3).
EFFECTIVE DATE: July 1, 2026
§ 1 — SAGA BENEFITS
The bill sets a standardized $269 monthly cash benefit for SAGA
beneficiaries (subject to future cost of living adjustments), and in doing
so, eliminates current law’s temporary payment reduction for certain
transitional people.
By law, SAGA generally provides cash assistance to single or
married childless people who have very low incomes, do not qualify for
other cash assistance programs, and are considered “transitional” or
“unemployable.” Under current law, monthly benefits are $2 62 for
sHB5040 File No. 403

sHB5040 / File No. 403 6

unemployable individuals and transitional recipients who must pay for
their shelter and $ 66 for transitional recipients who do not pay for
shelter (these benefit amounts account for annual cost of living
adjustments). For the latter , in practice DSS sends the transitional
person’s medical information to an independent reviewer , and if the
person is deemed medically unemployable, the person’s monthly
benefit retroactively increases to $262.
§ 2 — MEDICAID PREFERRED DRUG LIST AND ANTIRETROVIRAL
DRUGS
The bill adds antiretroviral drugs to the Medicaid preferred drug
lists, and in doing so, allows the state to negotiate supplemental rebates
with drug manufacturers for them. (This group of medications is used
to prevent and treat HIV.)
By law, DSS, in consultation with the Medicaid Pharmaceutical and
Therapeutics Committee, may establish a preferred drug list
(formulary) that limits the number of drugs that may be dispensed
under the Medicaid program. Nonpreferred drugs in the drug classes
included on the preferred drug list are subject to prior authorization.
Under current law, classes of antiretroviral drugs are exempt from prior
authorization requirements and cannot be included on preferred drug
lists.
§ 3 — PERIODIC REVIEW OF MEDICAID PRESCRIPTION DRUGS
The bill authorizes the DSS commissioner to periodically review
available data on the clinical effectiveness of Medicaid -covered
outpatient prescription drugs that are projected to exceed, after
factoring in rebates , (1) a per -consumer net cost of $25,000 per year or
(2) an aggregate annual cost to the program of $10 million.
Under the bill, the commissioner may, within available
appropriations, contract with a third party to conduct a comparative
effectiveness review of any of these prescription drugs. At a minimum,
this review must include the following:
1. clinical efficacy and outcomes;
sHB5040 File No. 403

sHB5040 / File No. 403 7

2. pricing-related information, such as prices paid by other states or
developed nations;
3. the prescription drug’s net price to the program compared to its
therapeutic benefits, such as the seriousness and prevalence of
the disease or condition the drug is treating;
4. the extent of the prescription drug’s use and the likelihood that
its use will reduce the need for other medical care;
5. how many manufacturers produce it; and
6. whether there are pharmaceutical equivalents.
Under the bill, the results of the review may be made public and
shared with any entity or multi -state prescription drug purchasing
collaborative that Connecticut is a member of , to help negotiate
additional supplemental rebate agreements beyond those required
under federal law.
COMMITTEE ACTION
Human Services Committee
Joint Favorable Substitute
Yea 23 Nay 0 (03/19/2026)