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SB970 • 2026

Creates provisions relating to cost-sharing under health benefit plans

Creates provisions relating to cost-sharing under health benefit plans

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Fitzwater, Travis; House handler: N/A
Last action
2026-04-20
Official status
Informal Calendar S Bills for Perfection
Effective date
2026-08-28

Plain English Breakdown

The plain English breakdown is still being put together. The official documents below are already here.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

SA 1 SS SCS

3/4/2026 - SA 1 to SS for SCS S offered & defeated (Lewis) • Lewis

Defeated

Plain English: Defeated 3/4/2026 - SA 1 to SS for SCS S offered & defeated (Lewis) by Lewis

  • This amendment summary is using official source text because generated interpretation was skipped for this run.
  • The official amendment text was available, but an easy plain-English summary could not be produced automatically during the last sync.
SA 2 SS SCS

3/4/2026 - SA 2 to SS for SCS S offered & adopted (Beck) • Beck

Adopted

Plain English: Adopted 3/4/2026 - SA 2 to SS for SCS S offered & adopted (Beck) by Beck

  • This amendment summary is using official source text because generated interpretation was skipped for this run.
  • The official amendment text was available, but an easy plain-English summary could not be produced automatically during the last sync.
SS SCS

3/4/2026 - SS for SCS S offered (Fitzwater) • Fitzwater

Offered

Plain English: Offered 3/4/2026 - SS for SCS S offered (Fitzwater) by Fitzwater

  • This amendment summary is using official source text because generated interpretation was skipped for this run.
  • The official amendment text was available, but an easy plain-English summary could not be produced automatically during the last sync.

Bill History

  1. 2026-04-20 Missouri House of Representatives and Missouri Senate

    Informal Calendar S Bills for Perfection

  2. 2026-03-04 S523

    Bill Placed on Informal Calendar

  3. 2026-03-04 S523

    SA 2 to SS for SCS S offered & adopted (Beck)--(5021S03.07S)

  4. 2026-03-04 S522-523

    SA 1 to SS for SCS S offered & defeated (Lewis)--(5021S03.03S)

  5. 2026-03-04 S522

    SS for SCS S offered (Fitzwater)--(5021S.03F)

  6. 2026-03-03 S515

    Bill Placed on Informal Calendar

  7. 2026-02-19 S415

    Reported from S Families, Seniors and Health Committee w/SCS

  8. 2026-02-04 Missouri House of Representatives and Missouri Senate

    SCS Voted Do Pass S Families, Seniors and Health Committee (5021S.02C)

  9. 2026-01-14 Missouri House of Representatives and Missouri Senate

    Hearing Conducted S Families, Seniors and Health Committee

  10. 2026-01-08 S129

    Second Read and Referred S Families, Seniors and Health Committee

  11. 2026-01-07 S48

    S First Read

  12. 2025-12-01 Missouri House of Representatives and Missouri Senate

    Prefiled

Official Summary Text

The following summaries of this bill are available:

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Senate Substitute

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SS/SCS/SB 970 - This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available.

Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available.

The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.

This act is similar to HB 79 (2025) and substantially similar to provisions in SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022).
TAYLOR MIDDLETON

Senate Committee Substitute

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SCS/SB 970 - This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available.

Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available.

The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.

This act is similar to HB 79 (2025) and substantially similar to provisions in SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022).
TAYLOR MIDDLETON

Introduced

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SB 970 - This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available.

Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available.

The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.

This act is identical to HB 79 (2025) and substantially similar to provisions in SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022).
TAYLOR MIDDLETON