TX SB1287

Requires health benefit plan issuers, pharmacy benefit managers, and subcontractors to apply any out-of-pocket expense reductions (such as manufacturer coupons or assistance programs) for prescription drugs classified as essential health benefits toward the enrollee's deductible, copayment, cost-sharing responsibility, or out-of-pocket maximum

Mandates these reductions be applied regardless of whether the insurer or pharmacy benefit manager classifies the specific drug as an essential health benefit, as long as it falls within a federal essential health benefits category under 42 U.S.C. Section 18022(b)(1)

Defines "subcontractor" as any person or entity (excluding employees) to whom a health benefit plan issuer or pharmacy benefit manager delegates functions, activities, or services

Applies to health benefit plans delivered, issued, or renewed on or after January 1, 2026

Takes effect September 1, 2025