Ohio's Senate Bill 207: Transforming Health Insurance Deductible Calculations

In 2025, Ohio introduced Senate Bill 207, a legislative proposal aiming to require health insurers to include all payment forms—such as coupons and copay assistance—in patients' deductible calculations. Spearheaded by Senators Susan Manchester and Beth Liston, this initiative seeks to address the AI-driven prior authorization delays and enhance regulatory compliance requirements. Following a previous legislative setback in late 2022, the current bill receives strong advocacy from the American Cancer Society Cancer Action Network of Ohio, which hopes for its passage to Governor Mike DeWine's office by year-end.

Many health insurance programs currently exclude payments facilitated by manufacturers from contributing to patients' out-of-pocket prescription costs, a practice Senate Bill 207 intends to change. The advocacy involves industry stakeholders, payers, and providers striving for a comprehensive overhaul. Julie Turner, a Hodgkin lymphoma survivor, highlighted the prohibitive nature of drug costs during advocacy campaigns in Columbus. "These uncredited manufacturer contributions do little to ease the financial burden," she noted, emphasizing the importance of equitable opportunities for life post-cancer.

Nationwide, over half of U.S. states have initiated prohibitions on copay accumulator programs, signaling a significant shift in how financial contributions are accounted for within insurance frameworks. This trend reflects broader industry and regulatory efforts to streamline claims processes, improve risk management, and enhance carrier accountability. As Senate Bill 207 progresses through legislative channels, it captures the attention of the insurance community focused on regulatory compliance and policy innovation.