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Bill > H3934


SC H3934

SC H3934
Cost sharing


summary

Introduced
02/06/2025
In Committee
02/06/2025
Crossed Over
Passed
Dead

Introduced Session

126th General Assembly

Bill Summary

Amend The South Carolina Code Of Laws By Adding Section 38-71-295 So As To Define Terms And To Include References To The Federal Internal Revenue Code For Purposes Of Cost Sharing; And By Adding Section 38-71-2270 So As To Define Terms And To Include References To The Federal Internal Revenue Code For Purposes Of Cost Sharing.

AI Summary

This bill amends the South Carolina Code of Laws by adding two new sections that regulate cost sharing in health insurance plans. The first section (38-71-295) and the second section (38-71-2270) are nearly identical, with the key difference being that the second section specifically addresses pharmacy benefit managers. The bill defines several terms, including "cost sharing" (copayments, coinsurance, deductibles), "enrollee" (an individual receiving healthcare services), and "health plan" (an insurance policy that covers healthcare services). The bill requires insurers and pharmacy benefit managers to apply the annual cost-sharing limitation from federal law to all healthcare services. It mandates that when calculating an enrollee's cost-sharing contribution, all amounts paid by the enrollee or on their behalf must be included, with specific provisions for Health Savings Account-qualified High Deductible Health Plans. The bill prohibits insurers and pharmacy benefit managers from setting health plan terms based on the availability of financial assistance for prescription drugs. These provisions will apply to health plans entered into, amended, extended, or renewed on or after January 1, 2026, and the state may only regulate insurers to the extent permitted by law. The bill takes effect upon the Governor's approval.

Committee Categories

Business and Industry

Sponsors (112)

Kevin Hardee (R)* Terry Alexander (D),  Carl Anderson (D),  Lucas Atkinson (D),  William Bailey (R),  Nathan Ballentine (R),  Justin Bamberg (D),  Bruce Bannister (R),  Heather Bauer (D),  Thomas Beach (R),  Beth Bernstein (D),  Phillip Bowers (R),  Jeff Bradley (R),  Gary Brewer (R),  Case Brittain (R),  Mike Burns (R),  Joe Bustos (R),  Paula Calhoon (R),  Micah Caskey (R),  Don Chapman (R),  Bill Chumley (R),  Bill Clyburn (D),  Gilda Cobb-Hunter (D),  Neal Collins (R),  Bobby Cox (R),  Brandon Cox (R),  Heather Crawford (R),  Sylleste Davis (R),  Chandra Dillard (D),  Adam Duncan (R),  Sarita Edgerton (R),  Shannon Erickson (R),  Greg Ford (R),  Cal Forrest (R),  Craig Gagnon (R),  Kambrell Garvin (D),  Gil Gatch (R),  Daniel Gibson (R),  Doug Gilliam (R),  Wendell Gilliard (D),  Thomas Lee Gilreath (R),  Jerry Govan (D),  Hamilton Grant (D),  Val Guest (R),  Brandon Guffey (R),  Patrick Haddon (R),  Bill Hager (R),  Chris Hart (D),  Tom Hartnett (R),  Charles Hartz (R),  Jackie Hayes (D),  Rosalyn Henderson-Myers (D),  Bill Herbkersman (R),  Lee Hewitt (R),  Davey Hiott (R),  Bill Hixon (R),  Harriet Holman (R),  Lonnie Hosey (D),  William Huff (R),  Jeff Johnson (R),  Jermaine Johnson (D),  Wendell Jones (D),  Jay Jordan (R),  Jay Kilmartin (R),  John King (D),  Roger Kirby (D),  Kathy Landing (R),  Brian Lawson (R),  Randy Ligon (R),  Steven Long (R),  Phillip Lowe (R),  Jason Luck (D),  David Martin (R),  John McCravy (R),  Annie McDaniel (D),  Tim McGinnis (R),  Cody Mitchell (R),  Scott Montgomery (R),  Travis Moore (R),  Dennis Moss (R),  Mike Neese (R),  Brandon Newton (R),  Weston Newton (R),  Melissa Oremus (R),  Jordan Pace (R),  Fawn Pedalino (R),  Tommy Pope (R),  Robert Reese (D),  Michael Rivers (D),  Robby Robbins (R),  Seth Rose (D),  Todd Rutherford (D),  Blake Sanders (R),  Carla Schuessler (R),  Keishan Scott (D),  Heath Sessions (R),  Mark Smith (R),  Tiffany Spann-Wilder (D),  Leon Stavrinakis (D),  Bill Taylor (R),  James Teeple (R),  Jackie Terribile (R),  David Vaughan (R),  Courtney Waters (D),  David Weeks (D),  Spencer Wetmore (D),  Joe White (R),  Bill Whitmire (R),  Paul Wickensimer (R),  Robert Williams (D),  Mark Willis (R),  Richie Yow (R), 

Last Action

Member(s) request name added as sponsor: Scott, M.M.Smith, Ford (on 01/14/2026)

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