By Glenn Mones

On November 2, nine members of Congress on both sides of the aisle introduced the Help Ensure Lower Patient Copays Act (HELP Copays Act), designed to prevent insurers from instituting “accumulator adjustor programs” and similar measures. These programs have allowed some insurers to force patients to pay the full cost sharing on expensive drugs such as clotting factor for hemophilia and many others, even when the copay has been covered by a nonprofit or other third-party. When such programs are permitted, they can present a severe financial hardship for the family or individual involved. The legislation was introduced by Representatives Donald McEachin (D-VA), Rodney Davis (R-IL), Bonnie Watson Coleman (D-NJ), Bobby Rush (D-IL), Brian Fitzpatrick (R-PA), Yvette Clarke (D-NY), Marc Veasey (D-TX), Buddy Carter (R-GA), and Barbara Lee (D-CA). It was supported by the All Copays Count Coalition, a diverse group of organizations representing patients affected by various chronic medical conditions who rely upon copay assistance payments.

This legislation is at an early stage. Like many healthcare bills, its sponsors may focus on gathering additional support for a time or may ultimately seek to combine it with other measures in a larger bill. A similar measure will also need to be introduced in the Senate. The Coalition for Hemophilia B will continue to update you as the effort moves forward, especially when you may be needed to contact your own elected representatives about the measure.