; and and inserting , or ; and (iii) by adding at the end the following new subparagraph: (F) insulin furnished as a covered outpatient drug (as defined in section 1927(k)(2)) and medical supplies associated with the injection of such insulin; and . (2) Alternative cost sharing limitation Section 1916A(c)(2) of the Social Security Act ( 42 U.S.C. 13960–1(c)(2) ) is amended by adding at the end the following new subparagraph: (D) Nonapplicability of cost sharing to insulin In no case may the cost sharing under paragraph (1)(A) apply with respect to insulin furnished as a covered outpatient drug (as defined in section 1927(k)(2)) and medical supplies associated with the injection of such insulin. . (3) Effective date (A) In general Subject to subparagraph (B), the amendments made by this subsection shall apply with respect to covered outpatient drugs furnished on or after January 1, 2020. (B) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this subsection, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.