Virginia lawmakers approve bill mandating insurance coverage for opioid overdose reversal medications

State Sen. Barbara A. Favola has introduced a newly approved bill designed to expand mandatory insurance coverage for opioid overdose reversal medications, requiring plans to include prescription as well as over-the-counter options, according to the Virginia State Senate.

The legislation passed in both chambers and was officially enrolled on March 30, 2026, with the House approving it 96-0 and the Senate 37-1.

The measure, filed as SB257 on Jan. 14, 2026, during the regular legislative session, was described by the General Assembly as: “Health insurance; requirements for certain opioid antagonists.”

Below is a summary based on the official bill text, with clarification for ease of understanding.

The bill mandates that most individual and group health insurance policies, along with health maintenance organization plans covering prescription drugs, must also offer coverage for prescription naloxone or any other opioid overdose reversal drug in the lowest cost formulary tier, and at least one over-the-counter opioid antagonist. For over-the-counter opioid antagonists, the law caps cost sharing at no more than the amount for the lowest tier covered drug and bans prior authorization and step therapy. Exemptions apply to certain limited or short-term policies. These requirements apply to coverage delivered, issued or renewed on or after Jan. 1, 2027.

In the House, 62 Democrats and 34 Republicans voted for the bill.

In the Senate, 20 Democrats and 17 Republicans supported the measure, with one Republican voting against it.

The legislation was sponsored by Sen. Barbara A. Favola (Democrat-40th District) and Sen. Kannan Srinivasan (Democrat-32nd District).

Favola holds a bachelor’s in science from Saint Joseph College, earned in 1977.

A Democrat, Favola was elected to the Virginia Senate in 2024, representing the 40th District after succeeding former state senator Todd Pillion.

The lawmaking process in Virginia begins when legislation is introduced in either the House of Delegates or Senate, where it is first assigned to committee for review and potential amendment. If approved in committee, the bill moves to the floor for debate and a vote in both chambers. Upon passage, it is sent to the governor for signature, veto, or passive enactment. The General Assembly meets annually, convening on the second Monday in January. Hundreds of bills are put forward each session, with only a portion advancing to law.

Information in this article was obtained from the Virginia State Senate. The source data can be found here.