Bill Sponsors
McGaw, Shekarchi, Hull, Craven, Corvese, J. Lombardi, Diaz, Donovan, and Kazarian
Committee
House Health & Human Services
Summary
Select
This legislation mandates that individual and group health insurance plans in Rhode Island provide coverage for glucagon medications, which are used to treat severe low blood sugar in people with diabetes. Specifically, insurers must cover at least one type of auto-injector, nasal spray, or ready-to-use formulation. Starting January 1, 2027, insurers are prohibited from charging copayments or deductibles for up to two of these units per year. However, plans paired with federally qualified Health Savings Accounts (HSAs) may still apply a deductible to remain compliant with federal tax laws.
Sponsor
Analysis
Pros for Progressives
- Eliminates financial barriers for diabetics to access life-saving emergency medication, ensuring that low-income individuals are not priced out of survival.
- Imposes necessary regulations on private insurance corporations, prioritizing public health outcomes and patient safety over corporate profit margins.
- Addresses health equity by ensuring that modern, easier-to-use formulations (like nasal sprays) are available to all patients, not just those who can afford high copays.
Cons for Progressives
- Includes a loophole for Health Savings Account (HSA) plans where deductibles can still be applied, potentially leaving some patients with high out-of-pocket costs.
- Delays the implementation of the benefit until January 1, 2027, leaving patients vulnerable to high costs for several more years.
- Limits the zero-cost benefit to only two doses per year, which may be insufficient for individuals with brittle diabetes who experience frequent hypoglycemic episodes.
Pros for Conservatives
- Includes specific exemptions for Health Savings Accounts (HSAs) to ensure state law does not conflict with federal tax codes or disqualify residents from tax-advantaged savings.
- Encourages the use of immediate treatments that prevent costly emergency room visits and hospitalizations, potentially lowering overall system costs in the long run.
- Allows insurance carriers the flexibility to choose at least one type of formulation to cover, rather than mandating coverage for every specific brand on the market.
Cons for Conservatives
- Imposes government mandates on private business contracts, interfering with the free market and the ability of insurers to design their own plan benefits.
- Likely results in increased insurance premiums for all ratepayers to subsidize the cost of "free" prescriptions for a specific group, redistributing costs to the general public.
- Removes the "skin in the game" (copays) for consumers, which is a mechanism typically used to control costs and encourage price-conscious healthcare consumption.
Constitutional Concerns
None Likely
Impact Overview
Groups Affected
- People with diabetes
- Health Insurance Companies
- Pharmacies
- Medical Providers
- Families of diabetics
Towns Affected
All
Cost to Taxpayers
Amount unknown
Revenue Generated
None
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Regulatory
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Environmental Impact
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Privacy Impact
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Bill Status
Current Status
Held
Comm Passed
Floor Passed
Law
History
• 01/14/2026 Introduced, referred to House Health & Human Services
Bill Text
SECTION 1. The general assembly hereby finds and declares that:
The Rhode Island general assembly recognizes that glucagon auto-injectors are life-saving medications, that must be administered quickly to be effective. Such administration is often done by persons who are not health care professionals, and is done in an emergency situation. Accordingly, it is in the best interests of the people of the state to promote the widespread availability of glucagon, that does not require reconstitution. Hypoglycemia, or low blood glucose, is a barrier to diabetes control, leads to worse clinical outcomes, stress, increased cost of care and polypharmacy. For unconscious patients, and those unable to ingest oral glucose, glucagon in the ambulatory setting is indicated, but often underutilized, due to excessive cost.
SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:
27-18-96. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
27-19-88. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
27-20-84. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
27-41-101. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and LC003546 - Page 2 of 4 no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 6. This act shall take effect upon passage.
The Rhode Island general assembly recognizes that glucagon auto-injectors are life-saving medications, that must be administered quickly to be effective. Such administration is often done by persons who are not health care professionals, and is done in an emergency situation. Accordingly, it is in the best interests of the people of the state to promote the widespread availability of glucagon, that does not require reconstitution. Hypoglycemia, or low blood glucose, is a barrier to diabetes control, leads to worse clinical outcomes, stress, increased cost of care and polypharmacy. For unconscious patients, and those unable to ingest oral glucose, glucagon in the ambulatory setting is indicated, but often underutilized, due to excessive cost.
SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:
27-18-96. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
27-19-88. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
27-20-84. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
27-41-101. Glucagon hypoglycemia medications.
Every individual or group health insurance contract, plan, or policy that provides prescription coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for at least one type of glucagon auto-injector, nasal spray or formulation not requiring reconstitution. There shall be no copayment required and LC003546 - Page 2 of 4 no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- reconstituted formulation covered by the contract, plan, or policy, every twelve (12) month plan year. A deductible may be applied to health plans that are paired with federally qualified health savings account pursuant to 26 U.S.C § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
SECTION 6. This act shall take effect upon passage.