Summary of HB 05054 - An Act Addressing Health Care Affordability

• Establishes the Prescription Drug Affordability Board (effective October 1, 2024) consisting of five members with expertise in health care economics, pharmacology, or clinical medicine to advise on reducing prescription drug costs while supporting innovation.

• Board shall identify prescription drugs meeting affordability thresholds starting October 1, 2026, including brand name drugs costing $30,000+ annually, drugs with $3,000+ price increases in 12 months, and generic drugs with excessive price spikes, then recommend cost containment strategies.

• Creates Cost Growth Benchmark Oversight Commission (effective July 1, 2024) with thirteen voting members to advise on implementation of health care cost growth benchmarks and quality standards for the state.

• Establishes procedures requiring health care entities exceeding cost growth benchmarks to file performance improvement plans with the Office of Health Strategy, with violations subject to civil penalties up to $500,000.

• Requires health insurance carriers (effective January 1, 2025) to annually demonstrate compliance with an affordability standard tied to the health care cost growth benchmark, with the Insurance Commissioner considering compliance when evaluating rate increase requests.