Proposed legislation would require Wisconsin insurance plans and pharmacy benefits managers to accept co-pay assistance towards annual drug co-pay totals.
During a Capitol press conference on Tuesday, patient advocate J.P. Summers said that financial assistance from some sources doesn’t count towards their drug deductibles. “It’s not fair for the insurance companies to accept these funds, use them up and then still expect the patient like myself to keep paying their deductible.”
Patient Deb Constantine said insurers are accepting those payments – and then billing patients again. “These policies require patients to pay the same amount twice, to get closer to their annual out of pocket limit or annual deductibles.”
The bill’s author, state Senator Andre Jacques (R-DePere) was asked what he’d say to insurers and pharmacy benefits managers that may object to the legislation.
“Well, I think I would say you already got your money,” Jacques said. “That’s kind of what we’re talking about here. I mean, it’s almost like a riddle you would tell your kids – when is a dollar not a dollar?. When somebody says that it’s not even though they pocketed it already.”
Jacques said measures banning the practice have been implemented in 14 other states, and Representative Lisa Subeck (D-Madison) said they’ve been effective. “And the sky has not fallen. Insurance companies haven’t gone out of business, pharmacy benefit managers are still in place. And those costs to the patients for those insurance products have not gone up. So I think we have evidence that this works.”