Senate debate on SB319 centers on requiring menopause care coverage

Senator Poore presented SB319 to the Senate Health and Social Services Committee, framing the bill as a response to gaps in access to menopause and perimenopause care. "This bill would require all insurance plans in the state of Delaware to cover medically necessary diagnostic and treatment services for menopause, perimenopause and their symptoms," Sen. Poore said.

The sponsor said covered services would include diagnostic testing, FDA-approved hormone therapies, pelvic-floor therapy and preventive care when medically necessary, and that medically necessary hormone-replacement therapy should not be subject to prior authorization or step-therapy requirements. The bill includes limited religious exemptions and applies to policies issued or renewed after Dec. 31, 2027.

Senator Buxton and other committee members pressed for information on the current coverage landscape and the potential fiscal impact. Kennedy Cook of the Delaware Department of Insurance said many plans already cover medically necessary menopause services and that the bill would standardize coverage. "Many insurance plans already cover menopause coverage services when medically necessary and so this would streamline the requirements and ensure that the requirement for coverage is uniform throughout health plans in the state of Delaware," Cook said.

Cook also provided formal comment on behalf of Insurance Commissioner Trinidad Navarro and the Department of Insurance, telling the committee the department does not anticipate a meaningful per-member-per-month premium impact and that Delaware would join several other states with similar mandates.

Committee members asked for follow-up and the sponsor indicated willingness to engage with stakeholders on operational details.