Bill Sponsors
Lauria, DiMario, Murray, Valverde, Kallman, Ujifusa, Pearson, Zurier, Urso, and Euer
Committee
Senate Health & Human Services
Summary
Select
This legislation requires Rhode Island health insurance providers to cover specific types of glucagon medication, which are used to treat severe low blood sugar in diabetics. Specifically, insurers must cover auto-injectors, nasal sprays, or other forms that do not need to be mixed before use. Starting January 1, 2027, insurance plans must cover two of these units per year with no copayment or deductible required from the patient. There is an exception regarding deductibles for plans associated with federally qualified Health Savings Accounts.
Sponsor
Analysis
Pros for Progressives
- Eliminates financial barriers to life-saving medication for diabetics by removing copayments and deductibles, ensuring that low-income individuals can access emergency care without fear of cost.
- Promotes health equity by mandating coverage for easier-to-use formulations (auto-injectors/nasal sprays), which helps those without medical training administer aid effectively during an emergency.
- Prioritizes patient welfare over corporate profit by forcing insurance companies to absorb the cost of these essential medications rather than passing them on to the sick.
Cons for Progressives
- The limitation to only two units per year may not be sufficient for all patients, particularly those with brittle diabetes who experience frequent emergencies.
- Includes a carve-out for federally qualified Health Savings Accounts (HSAs), which means wealthier individuals with these specific tax-advantaged plans may still face deductibles, maintaining a tiered system of access.
- Does not address the underlying high price of pharmaceutical drugs, acting as a band-aid solution that shifts costs to premiums rather than capping the price manufacturers can charge.
Pros for Conservatives
- Respects federal tax law by including specific exemptions for Health Savings Accounts (HSAs), ensuring the state law does not conflict with federal financial regulations.
- May reduce long-term healthcare costs by preventing catastrophic medical events resulting from untreated hypoglycemia, potentially lowering the overall burden on the healthcare system.
- The mandate is specific and limited to a life-saving emergency medication rather than a broad, sweeping intervention in the healthcare market.
Cons for Conservatives
- Imposes government mandates on private businesses (insurance companies), interfering with the free market and the right of companies to design their own benefit packages.
- Likely to result in increased insurance premiums for all policyholders, as companies will pass the cost of the "free" medication and zero-copay mandate onto the consumer base.
- Removes the consumer's "skin in the game" regarding cost, which violates market principles that suggest cost-sharing encourages responsible consumption of medical services.
Constitutional Concerns
None Likely
Impact Overview
Groups Affected
- Diabetics
- Health Insurance Companies
- Families of Diabetics
- Pharmacists
- Employers providing health benefits
Towns Affected
All
Cost to Taxpayers
Amount unknown
Revenue Generated
None
BillBuddy Impact Ratings
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Public Services
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Regulatory
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Clarity of Bill Language
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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
• 01/16/2026 Introduced, referred to Senate Health and Human Services
Bill Text
SECTION 1. Findings of fact
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 no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- LC003653 - Page 2 of 4 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 no deductible shall need to be met, to obtain two (2) glucagon auto-injectors, nasal spray or non- LC003653 - Page 2 of 4 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.