Pennsylvania 2025_0 Regular Session Status: In Committee Bipartisan · 12 D · 1 R cosponsors

HB 2652 — An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for prescription drug cost credits in health insurance; and imposing penalties.

Last action — Laid on the table, Sept. 8, 2026

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the House. Introduced June 22, 2026. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the House.

Prognosis

Advancing 42% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • In Committee

    Current position in the legislative process.

  • 13 sponsors

    1 primary, 12 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (12 D · 1 R) — cross-party backing.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

In plain language

This bill aims to reduce prescription drug costs for insured individuals in Pennsylvania.

The bill seeks to lower the costs of prescription drugs for those with health insurance in Pennsylvania. It also establishes penalties for non-compliance with new rules regarding drug pricing.

What this means for you
  • Consumers: Consumers with health insurance may benefit from lower prescription drug costs due to the new pricing measures.

Summary

Fair Prescription Costs

Bill Text

What changed in the latest version

267 added · 275 removed

Plain-language change summary

The recent changes to Bill HB 2652 include clarifications on terms related to health plan cost-sharing, specifically regarding how out-of-pocket expenses for prescription drugs are credited. The definitions of "cost-sharing" and "covered person" remained, but the formatting and structure were updated for consistency. These changes aim to make the bill clearer and easier to understand for those affected, potentially improving transparency for consumers when it comes to their healthcare costs.

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PRIOR PRINTER'S NO.
PRINTER'S NO.
3661 PRINTER'S NO.
3661 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.
3707 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.
WILLIAMS AND CIRESI, JUNE 18, 2026 AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 24, 2026 AN ACT Amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for prescription drug cost credits in health insurance;
WILLIAMS AND CIRESI, JUNE 18, 2026 REFERRED TO COMMITTEE ON INSURANCE, JUNE 22, 2026 AN ACT Amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for prescription drug cost credits in health insurance;
20260HB2652PN3707 - 2 - "Health care provider." A person who is licensed, certified or otherwise regulated to provide health care services under the laws of this Commonwealth.
"Health care provider." A person who is licensed, certified 20260HB2652PN3661 - 2 - or otherwise regulated to provide health care services under the laws of this Commonwealth.
20260HB2652PN3707 - 3 - § 5203.
§ 5203.
(a) Credits.--Except as provided in subsection (d), a prescription drug coverage administrator shall credit toward the covered person's in-network out-of-pocket maximum and other cost-sharing requirements an out-of-pocket expense that the covered person incurs by directly purchasing a prescription drug from a pharmacy or through a discount drug purchasing entity.
20260HB2652PN3661 - 3 - (a) Credits.--Except as provided in subsection (d), a prescription drug coverage administrator shall credit toward the covered person's in-network out-of-pocket maximum and other cost-sharing requirements an out-of-pocket expense that the covered person incurs by directly purchasing a prescription drug from a pharmacy or through a discount drug purchasing entity.
(2) The amount the covered person would have incurred if the covered person had obtained the same prescription drug in 20260HB2652PN3707 - 4 - the same plan year from an in-network pharmacy and under the terms of the covered person's health benefit plan.
(2) The amount the covered person would have incurred if the covered person had obtained the same prescription drug in the same plan year from an in-network pharmacy and under the 20260HB2652PN3661 - 4 - terms of the covered person's health benefit plan.
Nothing in this chapter shall require a health benefit plan to credit the cost share of a prescription drug in derogation of a policyholder's constitutional protections of religious freedom 20260HB2652PN3707 - 5 - under:
Nothing in this chapter shall require a health benefit plan to credit the cost share of a prescription drug in derogation of a policyholder's constitutional protections of religious freedom under:
(1) The act of December 9, 2002 (P.L.1701, No.214), known as the Religious Freedom Protection Act.
20260HB2652PN3661 - 5 - (1) The act of December 9, 2002 (P.L.1701, No.214), known as the Religious Freedom Protection Act.
20260HB2652PN3707 - 6 - (4) May require submission of satisfactory proof of purchase, including evidence of the purchase date and amount and the identification of the prescription drug purchased.
(4) May require submission of satisfactory proof of 20260HB2652PN3661 - 6 - purchase, including evidence of the purchase date and amount and the identification of the prescription drug purchased.
(a) Exemption.--The requirements of this chapter shall not apply to a prescription drug coverage administrator that contracts or has an arrangement with a pharmacy or discount drug purchasing entity that makes available a transparent pricing model to covered persons, if the prescription drug coverage administrator makes available all drugs covered under the terms 20260HB2652PN3707 - 7 - of the covered person's health benefit plan that are offered from that pharmacy or discount drug purchasing entity as part of the contract or arrangement with the health benefit plan.
(a) Exemption.--The requirements of this chapter shall not apply to a prescription drug coverage administrator that contracts or has an arrangement with a pharmacy or discount drug purchasing entity that makes available a transparent pricing model to covered persons, if the prescription drug coverage administrator makes available all drugs covered under the terms of the covered person's health benefit plan that are offered 20260HB2652PN3661 - 7 - from that pharmacy or discount drug purchasing entity as part of the contract or arrangement with the health benefit plan.
(B) LOSS OF EXEMPTION.--A PRESCRIPTION DRUG COVERAGE <-- ADMINISTRATOR THAT NO LONGER QUALIFIES FOR THE EXEMPTION UNDER THIS SECTION SHALL COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THIS CHAPTER WITHIN 60 DAYS AFTER THE DATE ON WHICH THE PRESCRIPTION DRUG COVERAGE ADMINISTRATOR FAILS TO MEET THE REQUIREMENTS FOR THE EXEMPTION, WHICH MAY BE EXTENDED AT THE DISCRETION OF THE COMMISSIONER.
(b) Definitions.--As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise:
(b) (C) Definitions.--As used in this section, the following <-- words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise:
20260HB2652PN3707 - 8 - § 5209.
§ 5209.
(1) Suspension or revocation of the offending entity's license or registration.
20260HB2652PN3661 - 8 - (1) Suspension or revocation of the offending entity's license or registration.
20260HB2652PN3707 - 9 - (3) The act of June 25, 1997 (P.L.295, No.29), known as the Pennsylvania Health Care Insurance Portability Act.
(3) The act of June 25, 1997 (P.L.295, No.29), known as the Pennsylvania Health Care Insurance Portability Act.
A party against whom penalties are assessed in an administrative action may appeal to Commonwealth Court as provided in 2 Pa.C.S.
A party against whom penalties are assessed in an administrative 20260HB2652PN3661 - 9 - action may appeal to Commonwealth Court as provided in 2 Pa.C.S.
20260HB2652PN3707 - 10 -
20260HB2652PN3661 - 10 -
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How this bill changes current law

6 changes Share ↗

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This bill adds a new chapter to Title 40 of the Pennsylvania Consolidated Statutes to require health insurance plans to provide credits for out-of-pocket costs of prescription drugs, with specific guidelines and exceptions.

  • Title 40

    CHAPTER 52 PRESCRIPTION DRUG COST CREDITS IN HEALTH INSURANCE Sec. 5201. Scope of chapter. 5202. Definitions. 5203. Prescription drug cost credit requirement. 5204. Exceptions. 5205. Protections. 5206. Submission process. 5207. Notice. 5208. Exemption. 5209. Regulations. 5210. Enforcement.

    Establishes a new chapter focused on prescription drug cost credits within health insurance law.

  • § 5203

    (a) Credits.--Except as provided in subsection (d), a prescription drug coverage administrator shall credit toward the covered person's in-network out-of-pocket maximum and other cost-sharing requirements an out-of-pocket expense that the covered person incurs by directly purchasing a prescription drug from a pharmacy or through a discount drug purchasing entity.

    Mandates that health insurers must credit direct out-of-pocket expenses for prescription drugs towards a covered person's in-network out-of-pocket maximum.

  • § 5204

    A prescription drug coverage administrator may decline to credit a covered person's out-of-pocket expense as required in section 5203 if:...

    Lists specific exceptions under which health insurers may not be required to credit expenses for prescription drugs.

  • § 5206

    Submission process: (a) Process required.--A prescription drug coverage administrator shall establish a streamlined process for a covered person to submit a request for credit of the covered person's payment for a prescription drug...

    Requires health insurance plans to create a process for covered individuals to submit claims for credit of out-of-pocket prescription drug expenses.

  • § 5207

    Maximum out-of-pocket.--Within 10 business days of becoming aware that a covered person reached the person's in-network maximum out-of-pocket limit, a prescription drug coverage administrator shall notify the covered person...

    Requires notification to insured individuals when they reach their maximum out-of-pocket limit concerning covered costs.

  • § 5208

    (a) Exemption.--The requirements of this chapter shall not apply to a prescription drug coverage administrator that contracts or has an arrangement with a pharmacy or discount drug purchasing entity that makes available a transparent pricing model to covered persons...

    Establishes an exemption for administrators that provide a transparent pricing model concerning prescription drug costs.

Action History

  1. Laid on the table, Sept. 8, 2026

  2. Re-reported as committed, Sept. 8, 2026

  3. Re-committed to RULES, June 24, 2026

  4. First consideration, June 24, 2026

  5. Reported as amended, June 24, 2026

  6. Referred to INSURANCE, June 22, 2026

Sponsors

Sponsorship breakdown

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1 sponsors · 12 co-sponsors · 240 not signed on

Sponsors (1)

Co-sponsors (12)

Not signed on (240)

240 members have not signed on to this bill.

Show all 240 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does HB 2652 do?
Fair Prescription Costs
Who sponsors HB 2652?
HB 2652 is sponsored by Emily Kinkead (Democratic), Jeanne McNeill (Democratic), Tarah Probst (Democratic), Manuel Guzman (Democratic), Kristine C. Howard (Democratic), Benjamin V. Sanchez (Democratic), Joseph C. Hohenstein (Democratic), Daniel J. Deasy (Democratic), Danielle Friel Otten (Democratic), Dan K. Williams (Democratic), Joe Ciresi (Democratic), Valerie S. Gaydos (Republican), and Chris Pielli (Democratic).
What is the current status of HB 2652?
This bill is in committee in the House. Introduced June 22, 2026. It must pass committee before a floor vote.
Where can I track HB 2652?
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