A Day at the State House: All Copays Count
Executive Director, Marissa Shackleton, gives testimony in support of patient assistance
Marissa Shackleton, Executive Director at The Elliot Lewis Center, gave testimony on May 2, 2023 to the Massachusetts Joint Committee on Financial Services in support of S. 609 and H. 953 “An Act relative to consumer deductibles”, an issue more commonly known as “all copays count”. These bills would prohibit copay accumulator policies and ensure all copays count toward a patient’s deductible and out-of-pocket maximum.
They will make sure patient support funding actually supports the patients, rather than allowing the insurance companies to get paid twice.
Marissa gave testimony as part of a panel with two patient advocates and a patient. The panel explained the detrimental impact to patients if these bills are not passed.
Often, patients are enrolled in patient assistance programs or copay programs to allow medications to be affordable and accessible. These funds contribute to the patient deductible and out-of-pocket. These bills would make sure it stays that way.
State House Reporter, Alison Kuzntiz, covered the hearing in her article, Here’s how your Mass. state legislators would like to improve your health care, on MassLive.
“Lawmakers on Tuesday also heard testimony about proposals from Rep. Daniel Cahill and Sen. Brendan Crighton (H 953/ S 609) aimed at closing an insurance loophole for deductibles that patients and activists say can currently result in insurers getting paid twice.
For example, a patient with multiple sclerosis may secure financial aid from a copay assistance program to blunt the yearly cost of medications that can total $94,000.
But that copay assistance — which insurers will accept — doesn’t necessarily count toward the patients’ deductibles, meaning they could still face a steep price tag the next time they pick up a prescription or need an MRI, said Marissa Shackleton, Executive Director of The Elliot Lewis Center for Multiple Sclerosis Care. To make ends meet, patients may manipulate their doctor’s instructions, such as taking a pill every other day instead of daily, but that could lead to ultimately more expenses in the form of hospital stays, symptom flare-ups and relapses.
“Not passing these bills would force patients to choose between paying for their medication and paying for their families’ needs,” Shackleton said. “Not passing these bills will lead to greater health care inequity, as only those who afford it will get the best medications.””