Protecting Patients from Higher Cost Sharing

  • by: |
  • 03/10/2015
While Congress waits to see what happens if the Supreme Court rules Obamacare subsidies are unconstitutional,  patients still need protection against the increase in out of pocket drug costs initiated by many health plans.  Thank goodness for federalism:

"Some states are taking action against insurers’ use of high-cost sharing for specialty medicines. Specialty medicines are typically used by patients with severe or rare health conditions, generally less than 5 percent of patients in the U.S., but are often subject to greater cost sharing and utilization management techniques. Policymakers in several states have passed legislation to limit the amount that patients pay for specialty medicines.

For example, Delaware, Maryland and Louisiana have passed laws that cap copays at $150 per month for a 30-day supply of a specialty medicine. New York State passed a law that prohibits insurers from requiring higher cost sharing for specialty medicines, which treat diseases like cancer and HIV, than they do for other brand name medications. Several more states are considering legislation this year."

Here's a list of states that have limited cost discrimination: 

And to find out what is going on in your state go to the National Patient Advocacy Foundation website or click here:

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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