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HB1638 Creating a bypass mechanism for health insurer step therapy protocols when medically necessary.

Healthcare Dead Auto-scored

Creating a bypass mechanism for health insurer step therapy protocols when medically necessary.

Impact Score — How Does This Bill Affect You?

7

Overall Impact Score

Mixed

Scale: 1 (harmful) to 10 (beneficial)

6
💰

Your Wallet

Patients could access needed medications faster, avoiding costs from failed treatments and worsened conditions during step therapy.

7
🏘️

Your Community

Gives doctors and patients more control over treatment decisions, improving health outcomes for those with complex conditions.

7
⚖️

Your Freedom

Restores medical decision-making authority to patients and doctors rather than insurance company protocols.

Status

Refer for Interim Study: Motion Adopted Voice Vote 03/11/2026 House Journal 7

Sponsor

David Nagel (R)

The Short Version

Would create a way for patients and doctors to bypass insurance step therapy (fail first) requirements when medically necessary. Step therapy forces patients to try cheaper medications first, even when doctors believe a different treatment is more appropriate.

Who's Behind This Bill?

Who Benefits

  • Patients with complex or rare conditions needing specific medications
  • Physicians seeking clinical autonomy
  • Patients suffering under fail-first requirements

Who Pays the Price

  • Health insurance companies managing drug costs through step therapy
  • Employers and policyholders if premiums increase slightly

Bill statuses as of May 2026. Check LegiScan or NH General Court for the latest.

This bill was auto-scored using AI analysis of the bill text and legislative data. Scores may be refined as we review more bills.