MADISON (WKOW) — Right now, Wisconsin lawmakers on both sides are working to ensure co-pay assistance programs benefit patients instead of insurance companies.
On Tuesday, Republicans and Democrats introduced All Copays Count legislation.
“This is about better patient outcomes,” Sen. Andre Jacqué (R-De Pere) said. “This is about making sure that people can afford their medications and not have to choose between groceries and gas.”
The bipartisan bill would ensure out of pocket payments and co-pay assistance count toward a patient’s maximum out of pocket cost or annual deductible. It would also close a loophole in the Affordable Care Act that allows employer sponsored health plans to deem certain prescriptions ‘non-essential.’
One lawmaker called the policy a “no brainer.”
“This is common sense. This is one of the easiest things that we can do to help patients at the pharmacy counter afford their prescriptions,” Rep. Lisa Subeck (D-Madison) said.
Several patients shared what the bill would mean to them Tuesday, including JP Summers, who suffers from chronic migraines.
“For me, a migraine attack is more than excruciating head pain. I have decreased motor skills, sensitivity to light sounds and odor and also, I have nausea,” Summers said.
Summers was forced to make a difficult decision when her assistance funds weren’t applied to her deductible and her son began experiencing migraines of his own.
“When my son was also diagnosed with migraines and needed expensive medications, I stopped taking my medicine for a while to put his health ahead of mine,” Summers said. “This was incredibly frustrating. Why should I have ever been put in a situation where I had to choose a loved one’s health over mine?”
Opponents of the All Copays Count legislation argue insurance costs would go up, but lawmakers at the Capitol pointed to over a dozen other states who have passed the legislation successfully.
“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 and works in a way that works for everybody,” Subeck said.
The bill is similar to legislation that failed last session.
