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Health Organizations Ask New York Assembly to Help Patients Struggling with Medication Costs

June 8, 2021

ALBANY, NY – Health organizations have joined forces to ask the New York Assembly to pass legislation that will help patients be able to pay for the health care they need.

The bill, commonly referred to as the Copay Accumulator bill (S5299 Rivera/A1741 Gottfried), will help patients struggling to pay for their medication. While the legislation passed the Senate earlier this year, the bill has not received a vote in the Assembly.

Some patients rely on financial assistance programs, such as a copay coupon or card, to reduce the cost of their medication.  But insurers are using a new tactic – called a copay accumulator adjustment, to undermine these financial assistance programs. Copay accumulator adjustments prevent patients from using a copay card or coupon to cover their out-of-pocket expenses.  Under this practice, when a patient uses a copay coupon or card, the health plan receives the payment from the card or coupon, yet the amount of the support provided by the coupon/card does NOT count toward the patient’s maximum out of pocket limit.  This legislation would ensure such payments benefit the patient rather than the insurer’s bottom line. 

“We need to put patients first.  Copay accumulators are unfair for patients,” said American Cancer Society Cancer Action Network (ACS CAN) Senior New York Government Relations Director, Julie Hart.  “It’s especially challenging for patients with high deductibles or high copayments. Ten states have now passed laws to stop insurers from using copay accumulators.  It’s time for New York to do the same and stop this misleading tactic.”

“Many of our patients rely upon needed medications to help recover from illness or to manage a life-threatening medical condition” stated Joseph Sellers, MD, President of the Medical Society of the State of New York. “With some patients facing significant out of pocket cost-sharing requirements such as high deductibles, health insurer-imposed copay Accumulators have a significant adverse affect upon patients living with chronic conditions like cancer, diabetes, and Multiple Sclerosis, just to name a few. MSSNY strongly supports legislation that would prohibit these co-pay accumulator policies and ensure that third party financial support will help patients to meet the cost of their medications.” 

“The New York State Assembly has a choice to make.  Putting patients before profits should be an easy choice.” said Lorraine Braithwaite-Harte, Health Chair, NAACP, New York State Conference.  “Copay accumulators are just another tactic to shift costs to patients.  It’s time for New York to stop this tactic and pass this bill to help keep medications affordable.”

"People with bleeding disorders already struggle to stay healthy. They shouldn't have to struggle to pay for their medications as well when there's help available. Accumulators will hurt people and this bill will protect people," added Bob Graham, Director of Policy for the New York State Bleeding Disorders Coalition.

“MS is an expensive disease to live with and treat, impacting the healthcare system, health plans and of course, families affected by MS. A person with MS spends three times as much out-of-pocket than the average person in employer plans. Until we find real solutions to the challenges in our healthcare system that prevent people from affordably accessing the care and treatments they need, we cannot rip away the band-aids people have come to rely on—like copay assistance programs,” said Jennifer Muthig-Director, Advocacy & Policy National Multiple Sclerosis Society

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About ACS CAN at 20 

The American Cancer Society Cancer Action Network (ACS CAN) makes cancer a top priority for policymakers at every level of government. ACS CAN empowers volunteers across the country to make their voices heard to influence evidence-based public policy change that saves lives. We believe everyone should have a fair and just opportunity to prevent, find, treat, and survive cancer. Since 2001, as the American Cancer Society’s nonprofit, nonpartisan advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and made workplaces, including restaurants and bars, smoke-free. As we mark our 20th anniversary, we’re more determined than ever to stand together with our volunteers and save more lives from cancer. Join the fight by visiting www.fightcancer.org

 

 

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Media Contacts

Marc Kaplan
Senior Regional Media Advocacy Manager
Albany, NY