Bipartisan bill looks to closing ACA loophole, support copay assistance

A new bill from the House of Representatives seeks to reduce patient costs by closing an ACA loophole regarding nonessential medications and requiring that payers consider copay assistance toward cost-sharing requirements. 

The bipartisan bill from Rep. Donald McEachin, D-Va., and Rodney Davis, R-Ill., dubbed the Help Ensure Lower Patient Copays Act, seeks to close a loophole that allows insurers to not cover potentially lifesaving treatment that they dub "nonessential," according to a news release shared with Becker's from advocacy group All Copays Count Coalition.

It also creates a federal rule requiring that payers count financial assistance toward deductibles or out-of-pocket maximums. Currently, 12 states have guidance on these copay accumulator adjustment policies. 

The bill received recent support from the All Copays Count Coalition — which includes the AIDS Institute and Arthritis Foundation — as well as 140 organizations representing patients. 

"These practices target the most financially vulnerable patients and erode coverage for preexisting conditions," said Lollet Koullianos, National Hemophilia Foundation senior director of payer relations. "If enacted, this legislation would bring much-needed relief by ensuring that all payments — whether they come directly from the patient or with the help of copay assistance — counts towards patient out-of-pocket responsibility."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Top 40 articles from the past 6 months