Joco Today

U.S. Senators Roger Marshall and Tim Kaine have introduced the Help Ensure Lower Patient (HELP) Copays Act. This legislation aims to eliminate certain pricing practices by insurance companies and pharmacy benefit managers (PBMs) that increase out-of-pocket costs for prescription drugs.

Senator Marshall stated, "Patient assistance programs help Americans pay for specialty medications that treat chronic and rare conditions." He emphasized the importance of applying patient assistance towards deductibles and out-of-pocket costs, urging colleagues to support the bipartisan HELP Copays Act.

Senator Kaine highlighted the role of copay assistance programs in making medications affordable for patients, saying, "Insurance companies and PBMs shouldn’t be able to extract additional profit by penalizing patients for using copay assistance programs." He noted Virginia's ban on such practices and expressed hope that the HELP Copays Act would extend these protections nationwide.

Many Americans with chronic illnesses face high costs due to deductibles and cost-sharing in their health insurance plans. While copay assistance can reduce these expenses, insurers and PBMs often do not credit this aid towards a patient's annual deductible or out-of-pocket maximum. As a result, when copay assistance is depleted, patients must cover full deductibles or maximums themselves. The HELP Copays Act seeks to ensure that all payments made on behalf of a patient count towards their annual financial obligations, improving access to necessary medications.

The legislation is also supported by Senators Thom Tillis, Lisa Murkowski, Ed Markey, and Jeff Merkley.