The Diabetes Patient Advocacy Coalition Applauds HR.5801 in Favor of Patient Equality
Copay Accumulator Adjustment Program Reform is Necessary to Alleviate Patient Cost Burdens
HR5801, introduced by Rep. Donald McEachin [D-VA-4] removes Copay Accumulator Adjustment Programs (CAAPs) at the federal level, requiring health insurers to count all payments made by patients directly or on their behalf toward their deductibles and overall out-of-pocket maximums. The Diabetes Patient Advocacy Coalition -- an alliance of people with diabetes, caregivers, patient advocates, health professionals, diabetes organizations and companies working collaboratively to promote and support public policy initiatives to improve the health of all 34.2 million Americans with diabetes -- applauds this patient forward action.
CAAPs have allowed insurance companies and pharmacy benefit managers (PBMs) to unfairly profit from patient care. Many Americans with chronic conditions rely upon manufacturer copay assistance to help pay for their prescriptions and are discovering this assistance doesn’t count toward their deductible and out-of-pocket max. Ultimately, people living with chronic diseases not only bear the burden of daily illness management but also predatory coverage policies. The substantial costs of living with a chronic illness are compounded year over year, penalizing and marginalizing high risk patients, and perpetuating medical inequity. According to the CDC, chronic diseases are the leading causes of death and disability, driving $3.8 trillion in annual health care costs (18% of the GDP).
“Predatory behaviors that threaten patient well-being must cease. DPAC is grateful to Rep. Rodney Davis[R-IL-13], Rep. Bobby L. Rush[D-IL-1], Rep. Brian K. Fitzpatrick [R-PA-1], Rep. Yvette D. Clarke[D-NY-9], Rep. Bonnie Watson Coleman,[D-NJ-12], Rep. Marc A. Veasey [D-TX-33], Rep. Earl L. "Buddy" Carter[R-GA-1] and Rep. Barbara Lee [D-CA-13] for their action in banning Copay Accumulator Adjustment Programs on behalf of chronic disease patients everywhere. This is a critical step in addressing patient inequities by immediately reducing the perverse financial incentives PBMs receive that skyrocket prescription drug costs for the consumer, and negate deductibles” said George Huntley, CEO of DPAC. “No American should be faced with dire financial choices between taking life-saving medication and putting food on their table. This example of less talk, more action on behalf of the 34 million people living with diabetes and millions more with other chronic conditions, is tremendous, many lives depend on it. Next steps are still needed to eliminate or modify rebate policies, and the misaligned incentives they cause in our healthcare system driving up prescription drug prices.”
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DPAC is a 501(c)(4) patient advocacy organization that turns knowledge into action through grassroots advocacy on behalf of the 122 million Americans with or at risk of diabetes. DPAC’s mission is to ensure quality of and access to care, medications, and devices for people living with diabetes; and to educate, inspire, and empower patient advocates as well as lawmakers toward meaningful action on diabetes.