SB 433: MEDICAID: Provides for Medicaid coverage of certain medications. (1/1/27) (EN +$3,000,000 GF EX See Note) - Louisiana

SB433 Original → SB433 Act 898 · 4 edits

MODERATE

This bill was updated from a draft proposal to its final enrolled version, adding the full list of sponsors and formalizing the effective date. The core policy regarding Medicaid weight loss coverage remains consistent, ensuring FDA-approved medications are covered for eligible recipients without step therapy requirements, though the final text adds flexibility for the Department of Health to set specific coverage criteria.

Scope change

The bill's scope expanded from a single sponsor to include multiple Senators and Representatives, reflecting broader legislative support and formal adoption.

SPONSORS

Added a comprehensive list of co-sponsors including Senators Barrow, Barthelemy, Duplessis, Jenkins, Owen, and Selders, and Representatives Bryant, Chassion, Fisher, Freeman, Green, Dana Henry, Jackson, Kerner, Knox, Lafleur, Mandie Landry, Terry Landry, Lyons, Marcelle, Martinez, McFarland, Miller, Moore, Murray, Muscarello, Newell, Phelps, Stagni, Walters, and Young.

ENACTMENT_PROCEDURE

Replaced the specific effective date of January 1, 2027 with a standard legal clause stating the law becomes effective upon signature, expiration of veto time, or legislative override, subject to available funding.

FISCAL

Added a requirement that the provisions only become effective if there is a specific appropriation of monies for their implementation.

FORMAL_STATUS

Updated the document header to indicate the bill is 'ENROLLED' and included signatures from the President of the Senate, Speaker of the House, and the Governor.

SB433 Enrolled → SB433 Original · 4 edits

MODERATE

The bill was renumbered and simplified from a multi-sponsor enrolled version to a single-sponsor original draft. The core policy remains the same: it mandates Medicaid coverage for FDA-approved weight loss medications for adults over 18 with a BMI of 30+ and a comorbidity, or a BMI of 35+. Key operational rules include a six-month initial coverage limit, a requirement to document clinical improvements for continued coverage, and a ban on step therapy. The effective date is set for January 1, 2027.

Scope change

The bill's scope of coverage and eligibility criteria remained unchanged, but the legislative text was streamlined from a complex enrolled version to a standard original draft format.

TECHNICAL

The bill header was changed from 'ENROLLED' with multiple sponsors to 'ORIGINAL' with a single sponsor, indicating a reset of the legislative drafting process.

TIMELINE

The effective date was explicitly set to January 1, 2027, replacing the previous conditional language regarding appropriations and gubernatorial signature.

REQUIREMENT

The text was consolidated to clearly mandate prior authorization limited to verifying patient eligibility and requiring documentation of clinical improvements for continued coverage.

The prohibition on step therapy was retained and clarified to apply to both the Department of Health and Medicaid managed care organizations.

SB433 Reengrossed → SB433 Enrolled · 3 edits · Jun 1, 2026

MINOR

The bill transitioned from a 'Reengrossed' draft to the final 'Enrolled' version, adding the names of all co-sponsors and formal signatures from legislative leaders. Substantively, the effective date changed from a fixed January 1, 2027, to a conditional start that depends on the governor's signature or a subsequent legislative override. Additionally, the law was modified to remove specific eligibility criteria, granting the Department of Health the authority to establish its own coverage rules instead.

Scope change

The bill's applicability shifted from a fixed implementation date to a flexible timeline contingent on the legislative approval process.

TIMELINE

The effective date was changed from a fixed date of January 1, 2027, to a conditional date that begins upon the governor's signature or, if vetoed, upon legislative approval.

ELIGIBILITY

Specific eligibility criteria were deleted from the text, and authority was granted to the Department of Health to establish its own coverage criteria.

TECHNICAL

The list of co-sponsors was expanded to include additional senators and representatives, and the document was finalized with official signatures from the Senate President, House Speaker, and Governor.

SB433 Engrossed → SB433 Reengrossed · 5 edits · Apr 29, 2026

MODERATE

The bill was reengrossed to shift weight loss medication coverage from a rigid set of specific eligibility criteria to a flexible system where the Department of Health establishes the rules. This change removes the age limit and specific BMI/comorbidity requirements, allowing the state to adjust coverage based on medical necessity and fiscal sustainability. Additionally, the bill clarifies that prior authorization is determined by the department and confirms that implementation depends on legislative funding.

Scope change

The bill's scope expanded from a fixed list of eligible patients to a broader mandate allowing the state to define eligibility criteria dynamically.

ELIGIBILITY

Removed the specific requirement for patients to be over 18 with a BMI of 35-39 and at least one comorbidity; eligibility is now established by the Department of Health.

REQUIREMENT

Changed prior authorization from a fixed verification of eligibility to a process determined entirely by the Department of Health.

Added a requirement for the Department of Health to implement coverage in a manner that ensures fiscal sustainability consistent with federal requirements.

Removed the specific rules limiting initial coverage to six months and requiring clinical improvement documentation for continued coverage.

Deleted the provision prohibiting the department from imposing additional restrictions beyond those in the bill.

MEDICAID: Provides for Medicaid coverage of certain medications. (1/1/27) (EN +$3,000,000 GF EX See Note)

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