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Thank you to everyone who joined us in Annapolis yesterday to show support for the Hemophilia Foundation of Maryland’s Advocacy Day. Together, we walked the halls of the Maryland Delegate and Senate offices to advocate against copay accumulators, a practice that unfairly burdens vulnerable patients while enriching insurance companies. It was inspiring to meet with legislators who back this initiative and to educate those less familiar with the topic. I could not be more proud of today’s advocates.
But our work is not done! Please take a minute to reach out to your legislators and ask them to vote YES for HB879 sponsored by Delegates S. Johnson and A. Johnson and SB595 sponsored Senator Hershey BEFORE 2/28. Your voice matters! Copy and paste the below message as a template. You can search your legislators by visiting: https://mgaleg.maryland.gov/mgawebsite/Members/District
Dear [Legislator’s Name],
As a constituent, I implore you to consider the financial burden of patients with chronic diseases and the vital role of patient assistance programs. I urge you to support HB879 and SB595, which would count all patient assistance towards out-of-pocket costs.
Treatments for rare and chronic diseases are often high-cost with no generic alternatives. As healthcare costs rise, so do patient shares like co-pays and deductibles. Many patients reach their annual out-of-pocket maximum within months and rely on financial assistance to afford life-saving medications.
Copay assistance programs, provided by non-profits, charities, and manufacturers, are not mere coupons. They were expanded as cost shares became unaffordable for most. Patients prescribed necessary medication can apply for copay assistance if they can’t afford the cost share. If approved, they can use the assistance annually.
Contrary to popular belief, 99.6% of copay assistance programs are for treatments without a generic alternative. Health plans still determine their formularies, and patients must still undergo prior authorization and other cost-saving processes.
Patients often believe they’ve met their out-of-pocket maximum with patient assistance programs. However, with the implementation of the Copay Accumulator Adjustment Program (CAAP), they’re required to pay the entire deductible before receiving their next shipment. The health plan receives the maximum out-of-pocket twice or more, once from the assistance program and once from the patient.
The phrase ‘Skin in the Game’ used by insurance companies overlooks the significant lifetime costs that patients with chronic diseases bear, including high premium costs and other financial challenges.
Banning CAAP in Maryland will have minimal impact on insurance costs. Recent reports indicate that allowing copay assistance to count towards out-of-pocket costs does not significantly increase premiums.
Please consider the immense burden that patients with chronic diseases bear and the crucial role of copay assistance programs. I urge you to vote in favor of HB879 and SB595 to ensure that all patient assistance counts towards out-of-pocket costs.
Thank you for your time and consideration.
Sincerely,
[Your Name]
[Your Contact Information]
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