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Iowa may ban insurers from requiring non-medical switching of prescriptions

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April 17th, 2024 by Ric Hanson

(Radio Iowa) – A bill on its way to the governor would prohibit insurance companies from forcing Iowa customers to switch to a different prescription drug if there’s no medical reason for the change — and the patient’s condition is stable. Substituting a less expensive generic drug for a brand name medication with the same active ingredients would still be allowed, however.

The bill will prevent insurance companies from denying coverage or requiring a higher co-payment in the middle of a health plan’s year. “I am just so happy to see this coming to fruition, finally, after seven years,” said Representative Thomas Moore of Griswold, a long-time advocate of the bill.

Rep. Thomas Jay Moore (R-Griswold) (official photo)

Representative Megan Srinivas, a physician from Des Moines, said she’s seen patients suffer from prescription drug switches ordered by their insurance company. “This was one of the main reasons that I really wanted to be a legislator, to help fix this issue and I was really excited to work on this as my very first bill when I became a legislator,” Srinivas said, “and it is very great to see that we’re going to do something so good for patient care.”

Insurance companies say the switches let them offer patients alternatives when pharmaceutical companies raise the price of a drug in the middle of an insurance plan’s year. Medicare, the government’s health care plan for seniors, prohibits midyear changes unless the federal agency that oversees the program authorizes it.