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2.17.16 While the Chronic Disease Coalition’s roots are in Oregon, the issues that brought us together are cropping up in communities all over the country – in Oregon but also in Idaho and Washington and beyond. Insurance companies continue to find ways to discriminate against people living with chronic conditions, whether through how they design benefits plans or how much they require patients to pay out-of-pocket for medications they need. So, who is affected by patient discrimination? It affects anyone with a chronic condition, such as diabetes, psoriasis, HIV, hemophilia, arthritis, cancer, multiple sclerosis, end stage renal disease – the list goes on and on. Just last year, a national study published in The New England Journal of Medicine confirmed evidence that insurers are using tactics to dissuade higher-cost patients from enrolling on their plans. Conducted by the Harvard T.H. Chan School of Public Health, the study looked at adverse tiering, when insurers put different types of drugs in different tiers for cost-sharing. The practice can put “substantial and potentially unexpected strain on people with chronic conditions,” the study found. Enrollees on plans with adverse tiering had an average annual cost per drug of $4,892, compared to $1,615 for enrollees in other types of plans. And while this analysis focused on pricing of drugs related to HIV, discrimination extends to other chronic health conditions as well. “Our findings suggest that many insurers may be using benefit design to dissuade sicker people from choosing their plans,” the researchers wrote. “A recent analysis of insurance coverage for several other high-cost chronic conditions such as mental illness, cancer, diabetes, and rheumatoid arthritis showed similar evidence of adverse tiering.” Do you have experience with this type of discrimination? Email us to let us know! If you’re interested in patient advocacy, you can sign up for updates by clicking here.