Rheingans Introduces Legislation to Help Michiganders Save on Prescriptions

LANSING, Mich., June 6, 2023 — State Rep. Carrie A. Rheingans (D-Ann Arbor) introduced legislation today to ensure that all payments made by or on behalf of insured patients will go toward their deductible and out-of-pocket costs.

“The copay assistance funds that drug manufacturers and other third parties, such as non-profit organizations, offer patients with very expensive medications doesn’t matter much if they don’t count toward a patient’s deductible or out-of-pocket maximum,” Rheingans said. “We need strong legislation to protect patients from having to pay that cost again out of their own pocket. Folks shouldn’t have to choose between dinner on the table or medication in the cabinet.”

State Rep. Bronna Kahle (R-Adrian) introduced a version of the bill in 2021. Although the bill passed the House with strong bipartisan support, it failed to receive a hearing in the Senate Committee on Health Policy and Human Services. The previous version of the bill garnered support from the Arthritis Foundation, National Psoriasis Foundation, Michigan All Copays Count Coalition, Michigan Society of Hematology and Oncology, the Association for Clinical Oncology and the National Multiple Sclerosis Society. 

“Copay accumulator programs are discriminatory health insurance practices that take advantage of copay assistance funds intended to help patients afford their high-cost, life-saving medications,” said Sarah Procario, advocacy director for the Hemophilia Foundation of Michigan and leader of the Michigan All Copays Count Coalition. “We are asking lawmakers to protect Michigan patients from insurance double-dipping that makes it so much harder for patients to afford the medicine they need.”

Patients are often unaware they are enrolled in one of these programs until they go to the pharmacy counter and realize they must pay the full cost of their medication, which can lead them to abandon or delay their prescription. These programs may be called different names, hidden deep in plan materials and marketed as a positive benefit, leading patients to lack awareness about their negative financial impacts.

“As a Michigander living with cystic fibrosis and impacted by a copay accumulator, I am thrilled to join Rep. Rheingans in the announcement of legislation that will prohibit insurers from continuing this harmful practice,” said Emily Schaller, founder and CEO of Rock CF Foundation. “No patient should be forced into debt to pay for the medication needed to maintain their health.”

AARP estimates that 28% of U.S. patients 19 to 64 years old skip medications because of their costs. In Michigan, however, the problem is more severe: 32% of this population skips medications due to cost.

“Almost every health insurance company in the state says that when a patient finds someone to help them afford their medicine, they will not count that help toward the patient’s deductible or out-of-pocket maximum,” said Cathy Patterson, a financial navigator with the Michigan Society of Hematology and Oncology, who works with patients each week struggling to navigate their insurance policies. “Patients who rely on copay assistance to afford their medication need a helping hand — not insurance company roadblocks. We’re incredibly grateful for Rep. Rheingans and her colleagues who are standing with us to tear those roadblocks down.”