What's happening
This bill requires New York health insurance policies to cover certain asthma inhalers at no out-of-pocket cost to patients.
Why it matters
Reduces financial barriers for asthma patients. by mandating that insurers cover both a rescue and a maintenance inhaler with no out-of-pocket costs (like copays or coinsurance), making essential asthma treatments more accessible.
Standardizes coverage across most health insurance plans. in New York, including individual, group, and health service corporation plans, ensuring broad and consistent access regardless of plan type.
Includes a key exception for high-deductible health plans (HDHPs). connected to Health Savings Accounts (HSAs); these plans may still require patients to pay toward their deductible if otherwise HSA eligibility would be lost, balancing federal tax rules with patient benefits.
Could improve asthma management and public health outcomes. by reducing the likelihood that cost will prevent patients from filling or using prescribed inhalers, potentially lowering emergency visits and long-term complications from poorly controlled asthma.
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Who cares
People with asthma
Those with covered prescription drug insurance would receive one form of prescribed rescue inhaler and one form of prescribed maintenance inhaler without cost-sharing, subject to a limited high-deductible plan exception.
Health insurers and health service corporations
Covered plans would have to provide asthma inhaler coverage and eliminate cost-sharing for one rescue and one maintenance option for policies issued or changed on or after January 1, 2027.
High-deductible health plan members
Their inhaler coverage could remain subject to the annual deductible if waiving it would make them ineligible for a health savings account.
Physicians and other authorized prescribers
Their prescriptions for asthma inhalers would qualify patients for the bill’s coverage requirements under covered plans.
Headline styles
Free Inhalers With Insurance
Plain English, a few words. Used as the page title.
Sponsors
3 Co-sponsors
History
- Substituted by A128A
- Ordered to third reading cal.1525
- Committee discharged and committed to rules
- Print number 1804a
- Amend (t) and recommit to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Free Inhalers With Insurance
Signed by Governor · Sponsor Jessica Gonzalez-Rojas
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1804--A
2025-2026 Regular Sessions
IN SENATE
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 Assembly, 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, copayment, 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 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.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00983-05-5
(B) Coverage shall be provided for one form of rescue and one form of maintenance inhaler that shall not be subject to a deductible, copayment, 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 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.
(2) Coverage shall be provided for one form of rescue and one form of maintenance inhaler that shall not be subject to a deductible, copayment, 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.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
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.
Read the full memo (639 words)
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.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.