Bill Analyses and Ratings
Bill Information: H0648 – Anticancer Medication Cost-Sharing Parity
Bill Summary
This bill creates new Section 41-1854 in Idaho Code, requiring health benefit plans issued or renewed after January 1, 2027, to apply identical cost-sharing requirements (copayments, coinsurance, and deductibles) to orally administered anticancer medications as they do to injected or intravenously administered anticancer medications. The legislation defines anticancer medications broadly as any drug or biologic used to kill, slow, or prevent the growth of cancerous cells, regardless of administration method.
The bill explicitly preserves insurers’ existing authority to manage costs through formularies, preferred drug lists, prior authorization requirements, and other utilization controls. This means health plans can still determine which specific medications they cover and require approval processes, but they cannot impose higher out-of-pocket costs on oral cancer medications compared to IV or injected versions. The act includes an emergency clause making it effective July 1, 2026.
Overall Assessment
This bill mandates that health insurers treat oral anticancer medications the same as IV or injected cancer drugs for cost-sharing purposes, potentially reducing out-of-pocket expenses for cancer patients who take oral medications. The legislation imposes new regulatory requirements on private health insurance plans, creating a government mandate that dictates coverage terms. While the bill aims to eliminate cost disparities that may discourage use of oral cancer treatments, it represents increased state regulation of private enterprise healthcare delivery.
Rating Breakdown
ARTICLE I. RESPONSIBILITY IN GOVERNMENT (-1)
Section 41-1854(2) creates a new state mandate requiring health benefit plans to structure their cost-sharing in a specific way, adding regulatory requirements on private insurance companies. This represents government intervention in private healthcare arrangements, imposing compliance obligations on insurers regarding how they design their benefit structures. The mandate dictates specific terms of coverage that health plans must offer, expanding government regulation of private enterprise.
ARTICLE II. CITIZEN INVOLVEMENT IN GOVERNMENT (0)
This bill regulates health insurance coverage requirements and does not address citizen participation in government, election processes, voting procedures, or political party operations.
ARTICLE III. EDUCATION (0)
The bill concerns health insurance coverage for anticancer medications and contains no provisions related to education policy, schools, curriculum, or parental rights in education.
ARTICLE IV. AGRICULTURE (0)
This legislation addresses health insurance requirements and has no connection to agriculture, farming, ranching, or agricultural education.
ARTICLE V. WATER (0)
The bill regulates health benefit plan coverage and does not address water rights, water management, or water policy.
ARTICLE VI. NATURAL RESOURCES AND ENVIRONMENT (0)
This legislation concerns health insurance coverage for medications and contains no provisions related to natural resources, environmental policy, or land management.
ARTICLE VII. ENERGY (0)
The bill addresses health insurance requirements and has no connection to energy policy, energy production, or energy independence.
ARTICLE VIII. IDAHO NATIONAL LABORATORIES (0)
This legislation regulates health benefit plans and does not address the Idaho National Laboratory, nuclear research, or technology development.
ARTICLE IX. PRIVATE PROPERTY RIGHTS (0)
The bill concerns health insurance coverage requirements and does not address property rights, takings, or land use regulations.
ARTICLE X. STATE AND FEDERAL LANDS (0)
This legislation addresses health insurance and contains no provisions related to state or federal land management or ownership.
ARTICLE XI. WILDLIFE MANAGEMENT (0)
The bill regulates health benefit plans and has no connection to wildlife management, hunting, fishing, or recreational access.
ARTICLE XII. ECONOMY (0)
While Section 41-1854(2) imposes new requirements on health insurers, the bill operates within the health insurance regulatory framework rather than directly addressing broader economic policy, commerce expansion, or business regulations. The mandate applies specifically to health benefit plan design rather than general business operations or economic development.
ARTICLE XIII. HEALTH AND WELFARE (-1)
Section 41-1854(2) mandates that health benefit plans "shall ensure" specific cost-sharing parity for oral anticancer medications, creating a government-imposed requirement on private health insurance. This represents increased regulation of private enterprise healthcare delivery systems. While the bill preserves some insurer flexibility through formularies and prior authorization in Section 41-1854(3), it fundamentally dictates coverage terms that private plans must follow, expanding government control over healthcare arrangements.
ARTICLE XIV. AMERICAN FAMILY (0)
The bill addresses health insurance cost-sharing for anticancer medications and does not address family values, marriage, parental rights, or right to life issues.
ARTICLE XV. OLDER AMERICANS (0)
While cancer treatment affects older populations, the bill applies uniformly to all health benefit plans without specific provisions targeting older Americans or addressing policies that penalize working seniors.
ARTICLE XVI. LAW AND ORDER WITH JUSTICE (0)
This legislation concerns health insurance coverage and contains no provisions related to criminal justice, law enforcement, gun rights, or sentencing.
ARTICLE XVII. NATIONAL DEFENSE – SECURING THE BORDER (0)
The bill regulates health benefit plans and has no connection to military policy, veterans' affairs, national defense, or border security.
ARTICLE XVIII. ELECTION OF JUDGES AND IDAHO SUPREME COURT JUSTICES (0)
This legislation addresses health insurance requirements and does not concern judicial elections, court procedures, or constitutional interpretation.
ARTICLE XIX. RELIGIOUS LIBERTY (0)
The bill regulates health insurance coverage for anticancer medications and contains no provisions related to religious freedom, free exercise of religion, or conscience protections.