NY State Bill 2025-S1804A

Current Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 28, 2025	print number 1804a
May 28, 2025	amend (t) and recommit to insurance
Jan 13, 2025	referred to insurance

Bill Amendments

Original

A (Active)

co-Sponsors

2025-S1804 - Details

See Assembly Version of this Bill:: A128
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2023-2024 Legislative Session:: S9906, A10692

2025-S1804 - Summary

Requires insurance coverage for one rescue and one maintenance inhaler at no cost.

2025-S1804 - Sponsor Memo

                                 
BILL NUMBER: S1804

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring coverage of
asthma inhalers at no cost

 
PURPOSE OR GENERAL IDEA OF BILL:  To allow patients to access asthma
inhalers without being subjected to cost sharing.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends subsection (i) of section 3216 of the insurance law to
require that every insurance policy include coverage for inhalers for
the treatment of asthma. The section also requires that coverage would
not be subject to a deductible, copayment, coinsurance, or any other
cost-sharing requirement.

Section 2 amends subsection (I) of section 3221 of the insurance law to
require that every health insurance policy require coverage for inhalers
for the treatment of asthma and that coverage shall not be subject to a

deductible, copayment, coinsurance, or any other cost-sharing require-
ment.

Section 3 amends section 4303 of the insurance law to add a new
subsection to require a medical expense indemnity corporation or health
service corporation to include coverage for inhalers for the treatment
of asthma coverage shall not be subject to a deductible, co-payment,
coinsurance or any other cost-sharing requirement.

Section 4 sets the effective date.

 
JUSTIFICATION:

According to the U.S. Food and Drug Administration, more than 20 million
adults and over 4.5 million children were living with asthma in 2022.
Despite this reality, nothing has been done to reduce the cost of asthma
inhalers as the price of each life-saving device can be as high as $640
a month in some instances. Even with health insurance, individuals are
subjected to significant expenses to access this life-saving medication.
Typically, patients experience these costs through plan deductibles,
copayments, or coinsurance charges generally referred to as cost shar-
ing. The results are predictable and devastating. Without consistent
access to inhalers, people with asthma and chronic obstructive pulmonary
disease (COPD) are more likely to get sick, be hospitalized, and die.

The U.S. Centers for Disease Control (CDC) has found that asthma kills
about 10 people every day, while COPD kills about 390 people every day
and is the sixth-leading cause of death in the United States.  Asthma
and COPD also place a strain on our healthcare system. Per the CDC, each
year, asthma is responsible for more than 1.7 million emergency depart-
ment visits and over $50 billion in healthcare costs.  According to the
New York State Department of Health, in New York alone more than 1.4
million adults have asthma. The issue is prevalent among children as
well. The US Centers for Disease Control (CDC) found that in 2021, New
York State had an estimated 315, 000 children with asthma, which was
about 8.9% of children in the state.

The concept of cost-sharing was developed to reduce the unnecessary use
of medical services and supplies. To apply cost sharing to life-saving
medications connected to chronic diseases such as asthma highlights a
failing of our current system. We are charging those with illnesses more
money to access life-saving services and medications that no reasonable
person could call unnecessary. This bill will directly address the issue
by eliminating cost-sharing for these medications similar to the elimi-
nation of cost-sharing for insulin, which was signed into law in 2024.
This bill is an important step forward to redressing the failings of how
our current healthcare system is designed.

 
PRIOR LEGISLATIVE HISTORY:

2024: S9906 Rivera / A10692 Gonzalez-Rojas

 
FISCAL IMPLICATIONS:

Undetermined

 
EFFECTIVE DATE:
This act shall take effect immediately.

2025-S1804 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1804
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2025
                                ___________
 
 Introduced  by  Sens. RIVERA, ADDABBO -- read twice and ordered printed,
   and when printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in relation to requiring coverage  of
   asthma inhalers at no cost
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
 amended by adding a new paragraph 40 to read as follows:
   (40)  (A)  EVERY  POLICY WHICH PROVIDES MEDICAL COVERAGE THAT INCLUDES
 COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY
 WHICH PROVIDES MAJOR  MEDICAL  OR  SIMILAR  COMPREHENSIVE-TYPE  COVERAGE
 SHALL  INCLUDE  COVERAGE  FOR  INHALERS  FOR  THE TREATMENT OF ASTHMA IF
 RECOMMENDED OR PRESCRIBED BY A PHYSICIAN OR OTHER LICENSED  HEALTH  CARE
 PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCA-
 TION LAW.
   (B)  SUCH  COVERAGE  SHALL  NOT BE SUBJECT TO A DEDUCTIBLE, COPAYMENT,
 COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY GROUP OR BLANKET ACCIDENT AND HEALTH  INSURANCE  POLICY
 ISSUED  OR  ISSUED  FOR  DELIVERY  IN  THIS STATE WHICH PROVIDES MEDICAL
 COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A  PHYSICIAN'S
 OFFICE  AND EVERY POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPRE-
 HENSIVE-TYPE COVERAGE SHALL INCLUDE COVERAGE FOR INHALERS FOR THE TREAT-
 MENT OF ASTHMA IF RECOMMENDED OR PRESCRIBED  BY  A  PHYSICIAN  OR  OTHER
 LICENSED  HEALTH  CARE  PROVIDER  LEGALLY  AUTHORIZED TO PRESCRIBE UNDER
 TITLE EIGHT OF THE EDUCATION LAW.
   (B) SUCH COVERAGE SHALL NOT BE SUBJECT  TO  A  DEDUCTIBLE,  COPAYMENT,
 COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ww) to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00983-01-5

 S. 1804                             2
 
   (WW) (1) A MEDICAL EXPENSE INDEMNITY CORPORATION OR A  HEALTH  SERVICE
 CORPORATION  WHICH  PROVIDES MEDICAL COVERAGE THAT INCLUDES COVERAGE FOR
 PHYSICIAN SERVICES IN  A  PHYSICIAN'S  OFFICE  AND  EVERY  POLICY  WHICH
 PROVIDES  MAJOR  MEDICAL  OR  SIMILAR  COMPREHENSIVE-TYPE COVERAGE SHALL
 INCLUDE COVERAGE FOR INHALERS FOR THE TREATMENT OF ASTHMA IF RECOMMENDED
 OR  PRESCRIBED  BY  A  PHYSICIAN  OR OTHER LICENSED HEALTH CARE PROVIDER
 LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW.
   (2) SUCH COVERAGE SHALL NOT BE SUBJECT  TO  A  DEDUCTIBLE,  COPAYMENT,
 COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   §  4.  This  act  shall take effect immediately and shall apply to all
 policies and contracts issued, renewed, modified, altered, or amended on
 or after such date.

co-Sponsors

2025-S1804A (ACTIVE) - Details

See Assembly Version of this Bill:: A128
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in 2023-2024 Legislative Session:: S9906, A10692

2025-S1804A (ACTIVE) - Summary

Requires insurance coverage for one rescue and one maintenance inhaler at no cost.

2025-S1804A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1804A

SPONSOR: RIVERA
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring coverage of
certain asthma inhalers at no cost

 
PURPOSE OR GENERAL IDEA OF BILL:

To allow patients to access asthma inhalers without being subjected to
cost sharing.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1 amends subsection (i) of section 3216 of the insurance law to
require that every insurance policy include coverage for inhalers for
the treatment of asthma. The section also requires that coverage would
at a minimum provide the plan enrollee have access to at least one
rescue and one maintenance inhaler that is not subject to a deductible,
copayment, coinsurance, or any other cost-sharing requirement.

Section 2 amends subsection (I) of section 3221 of the insurance law to
require that every health insurance policy require coverage for inhalers
for the treatment of asthma. The section also requires that coverage
would at a minimum provide the plan enrollee have access to at least one
rescue and one maintenance inhaler that is not subject to a deductible,
copayment, coinsurance, or any other cost-sharing requirement.

Section 3 amends section 4303 of the insurance law to add a new
subsection to require a medical expense indemnity corporation or health
service corporation to include coverage for inhalers for the treatment
of asthma. The section also requires that coverage would at a minimum
provide the plan enrollee have access to at least one rescue and one
maintenance inhaler that is not subject to a deductible, copayment,
coinsurance, or any other cost-sharing requirement.

Section 4 sets the effective date.

 
JUSTIFICATION:

According to the U.S. Food and Drug Administration, more than 20 million
adults and over 4.5 million children were living with asthma in 2022.
Despite this reality, nothing has been done to reduce the cost of asthma
inhalers as the price of each life-saving device can be as high as $640
a month in some instances. Even with health insurance, individuals are
subjected to significant expenses to access this life-saving medication.
Typically, patients experience these costs through plan deductibles,
copayments, or coinsurance charges generally referred to as cost shar-
ing. The results are predictable and devastating. Without consistent
access to inhalers, people with asthma and chronic obstructive pulmonary
disease (COPD) are more likely to get sick, be hospitalized, and die.

The U.S. Centers for Disease Control (CDC) has found that asthma kills
about 10 people every day, while COPD kills about 390 people every day
and is the sixth-leading cause of death in the United States.  Asthma
and COPD also place a strain on our healthcare system. Per the CDC, each
year, asthma is responsible for more than 1.7 million emergency depart-
ment visits and over $50 billion in healthcare costs.  According to the
New York State Department of Health, in New York alone more than 1.4
million adults have asthma. The issue is prevalent among children as
well. The US Centers for Disease Control (CDC) found that in 2021, New
York State had an estimated 315, 000 children with asthma, which was
about 8.9% of children in the state.

The concept of cost-sharing was developed to reduce the unnecessary use
of medical services and supplies. To apply cost sharing to life-saving
medications connected to chronic diseases such as asthma highlights a
failing of our current system. We are charging those with illnesses more
money to access life-saving services and medications that no reasonable
person could call unnecessary. This bill will directly address the issue
by eliminating cost-sharing for these medications similar to the elimi-
nation of cost-sharing for insulin, which was signed into law in 2024.
This bill is an important step forward to redressing the failings of how
our current healthcare system is designed.

 
PRIOR LEGISLATIVE HISTORY:

2024: S9906 Rivera / A10692 Gonzalez-Rojas

 
FISCAL IMPLICATIONS:

Undetermined

 
EFFECTIVE DATE:
Takes effect January 1, 2027.

2025-S1804A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1804--A
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 13, 2025
                                ___________
 
 Introduced by Sens. RIVERA, ADDABBO, GONZALEZ, JACKSON -- read twice and
   ordered  printed, and when printed to be committed to the Committee on
   Insurance -- committee discharged, bill amended, ordered reprinted  as
   amended and recommitted to said committee
 
 AN  ACT to amend the insurance law, in relation to requiring coverage of
   certain asthma inhalers at no cost
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 41 to read as follows:
   (41) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR
 COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE FOR PRESCRIPTION DRUGS
 SHALL INCLUDE COVERAGE FOR INHALERS  FOR  THE  TREATMENT  OF  ASTHMA  IF
 PRESCRIBED BY A PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY
 AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW.
   (B)  COVERAGE SHALL BE PROVIDED FOR ONE FORM OF RESCUE AND ONE FORM OF
 MAINTENANCE INHALER THAT SHALL NOT BE SUBJECT TO  A  DEDUCTIBLE,  COPAY-
 MENT, COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   (C)  IF  THE  POLICY  IS  A  HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
 SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF  1986,  SUCH  COVERAGE
 MAY  BE  SUBJECT  TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
 REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY GROUP OR BLANKET ACCIDENT AND HEALTH  INSURANCE  POLICY
 ISSUED  OR  ISSUED  FOR  DELIVERY  IN THIS STATE WHICH PROVIDES MEDICAL,
 MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVER-
 AGE FOR PRESCRIPTION DRUGS SHALL INCLUDE COVERAGE FOR INHALERS  FOR  THE
 TREATMENT  OF  ASTHMA  IF  PRESCRIBED  BY  A PHYSICIAN OR OTHER LICENSED
 HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER  TITLE  EIGHT
 OF THE EDUCATION LAW.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00983-05-5

 S. 1804--A                          2
 
   (B)  COVERAGE SHALL BE PROVIDED FOR ONE FORM OF RESCUE AND ONE FORM OF
 MAINTENANCE INHALER THAT SHALL NOT BE SUBJECT TO  A  DEDUCTIBLE,  COPAY-
 MENT, COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   (C)  IF  THE  POLICY  IS  A  HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
 SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF  1986,  SUCH  COVERAGE
 MAY  BE  SUBJECT  TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
 REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ww) to read as follows:
   (WW)  (1)  A MEDICAL EXPENSE INDEMNITY CORPORATION OR A HEALTH SERVICE
 CORPORATION WHICH PROVIDES MEDICAL, MAJOR MEDICAL OR SIMILAR  COMPREHEN-
 SIVE-TYPE  COVERAGE  AND  PROVIDES COVERAGE FOR PRESCRIPTION DRUGS SHALL
 INCLUDE COVERAGE FOR INHALERS FOR THE TREATMENT OF ASTHMA IF  PRESCRIBED
 BY A PHYSICIAN OR OTHER LICENSED HEALTH CARE PROVIDER LEGALLY AUTHORIZED
 TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW.
   (2)  COVERAGE SHALL BE PROVIDED FOR ONE FORM OF RESCUE AND ONE FORM OF
 MAINTENANCE INHALER THAT SHALL NOT BE SUBJECT TO  A  DEDUCTIBLE,  COPAY-
 MENT, COINSURANCE OR ANY OTHER COST-SHARING REQUIREMENT.
   (3)  IF  THE  POLICY  IS  A  HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
 SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF  1986,  SUCH  COVERAGE
 MAY  BE  SUBJECT  TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
 REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
   § 4. This act shall take effect January 1, 2027 and shall apply to all
 policies and contracts issued, renewed, modified, altered, or amended on
 or after such date.

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Senate Bill S1804A

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2025-S1804 - Details

2025-S1804 - Summary

2025-S1804 - Sponsor Memo

2025-S1804 - Bill Text download pdf

co-Sponsors

2025-S1804A (ACTIVE) - Details

2025-S1804A (ACTIVE) - Summary

2025-S1804A (ACTIVE) - Sponsor Memo

2025-S1804A (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S1804A

Share this bill

Sponsored By

Gustavo Rivera

Current Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

Joseph P. Addabbo Jr.

Kristen Gonzalez

Robert Jackson

2025-S1804 - Details

2025-S1804 - Summary

2025-S1804 - Sponsor Memo

2025-S1804 - Bill Text download pdf

co-Sponsors

Joseph P. Addabbo Jr.

Kristen Gonzalez

Robert Jackson

2025-S1804A (ACTIVE) - Details

2025-S1804A (ACTIVE) - Summary

2025-S1804A (ACTIVE) - Sponsor Memo

2025-S1804A (ACTIVE) - Bill Text download pdf

Comments