Too often, chronic disease patients experience barrier after barrier from their insurance providers when trying to access the critical treatment needed to control their health condition. Although not always easy, one of the most direct ways to elicit change and improve access to care for patients is through creation of new policy and passage of legislation to address longtime, established provider loopholes. This legislative session – on both the state and federal level – brings hope for chronic disease patients. Many lawmakers plan to use 2018 to addresses some of the biggest barriers chronic disease patients face when accessing health care. Learn about five federal and state bills we’re tracking at the Chronic Disease Coalition that are poised to make a difference for chronic disease patients:
Patients who pay their insurance premiums shouldn’t have to worry about losing coverage. However, due to rising insurance costs, many patients use financial assistance from charitable organizations to help afford their medical bills. Unfortunately, in at least 42 states, patients are being told they’ll be dropped from their health plans if they accept charitable financial aid. This devious tactic allows insurers to steer chronic disease patients away from their private plans onto public plans like Medicare and Medicaid – prohibiting patients from choosing the health care plan that works best for them.
Thankfully, the bipartisan Access to Marketplace Insurance Act, or H.R. 3976, would prevent insurers from discriminating against patients who rely on charitable financial aid to help afford their insurance premiums and co-pays by officially authorizing charities to provide financial assistance.
Iowa H.S.B. 516 and S.S.B. 3003
Two companion bills, H.S.B. 516 and S.S.B. 3003, have been introduced in Iowa’s House and Senate respectively. Insurers commonly force patients off of medication prescribed by their physician and onto cheaper, often less effective alternatives – sometimes in the middle of the year and after they’ve been on a medication for a long time. These pieces of legislation address this issue by prohibiting insurers from switching patients onto cheaper medication for nonmedical reasons.
Both bills must be moved out of committee by Feb. 16, or patients in Iowa will remain unprotected from greedy insurers.
With over 122 co-sponsors, H.R. 1409 would amend the existing Public Health Service Act so cancer patients aren’t required to pay more for receiving certain treatment administered by either a health care provider or themselves. Also called the Cancer Drug Parity Act, the bill prohibits health plans from changing or reclassifying benefits to increase a patient’s out-of-pocket costs and keeps them from applying more restrictive limitations on orally administered medication than injected medications.
With passage of this bill, cancer patients will have greater freedom to choose the treatment option their doctor believes is best for them.
Florida S.B. 98
This bipartisan bill addresses harmful step therapy and prior authorization practices that make it more difficult for patients to receive the treatment their doctor prescribed. Today, insurers are increasingly forcing patients to try and “fail” a cheaper treatment than was prescribed by their doctor – creating a delay in the time for patients to receive proper care. Florida’s Senate Bill 98 creates exceptions that require insurers to cover a specific medication if trying a cheaper therapy could actually worsen a patient’s condition.
S.B. 98 also addresses time-consuming prior authorization requests by shortening the timeframe insurers have to respond to a doctor’s request to prescribe certain medications for patients. Previously, insurers had two weeks to respond to nonurgent prior authorization requests, but this bill shortens that time period to three days.
This bill is poised to make a difference for patients who need to receive their medication in a timely fashion. The legislation recently passed through the Florida Senate and now awaits discussion in the House.
Oregon H.B. 4156
Oregon lawmakers have introduced patient-centered legislation, H.B. 4156, which prohibits insurance companies from making certain changes to prescription drug coverage during the year. This works to protect patients from harmful step therapy practices and ensures they are able to receive the medication their doctor prescribed. In addition, this bill provides patients with consistency by restricting co-pay or deductible increases throughout the year.