GLHF Testifies Before the Assembly Health Committee About Harmful Insurance Practices Including PBMs and Copay Accumulator Adjuster Programs

Great Lakes Hemophilia Foundation and community advocates spent the day in Madison on February 14 educating legislators and showing support for the Pharmacy Benefit Manager Accountability Bill/Copay Accumulator Adjuster Program Bill. This important bipartisan legislation will protect local pharmacists and help Wisconsin patients access their medications by ensuring that commercial health plans count the value of copay assistance toward a patient’s deductible.

Many patients, especially those with rare and chronic diseases, rely on copay assistance to afford their medications. However, health insurers in Wisconsin are increasingly implementing copay accumulator adjustment program policies that don’t count the value of copay assistance toward a patient’s annual deductible or out-of-pocket maximum. These policies allow health plans to increase their profits by requiring patients to pay the same amount twice to get closer to their annual out-of-pocket limit. A report from The AIDS Institute found that 8 out of 13 commercially available insurance plans in Wisconsin are implementing copay accumulator policies. This means that millions of patients in Wisconsin are at risk right now.

To date, 19 states, Washington, DC, and Puerto Rico have passed legislation that requires health insurers to count the value of copay assistance towards the patient’s cost-sharing responsibilities. 

Tracie, a GLHF Board Member, community advocate, and the mother of a child with hemophilia, testified at the Assembly for Health Aging and Long-Term Care Committee Hearing, articulating her support for this legislation and asking the committee to protect patients from harmful insurer and pharmacy benefit manager (PBM) practices that harm patient access.  

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