Payne, McKinley, Capps Introduce Legislation to Ensure Access to Life-Saving Treatments

Mar 25, 2015 Issues: Health Care

Washington, D.C. – Congressman Donald M. Payne, Jr. (NJ-10) joined Congressman David McKinley (WV-1) and Congresswoman Lois Capps (CA-24) in introducing the Patient Access to Treatments Act of 2015, bipartisan legislation to provide millions of Americans with access to critical life-saving treatments.

“When health insurers place drugs in specialty tiers, necessary medical treatments become unaffordable for millions of Americans,” said Congressman Payne, Jr. “Those who cannot afford specialty tier pricing are forced to underutilize treatment or go without treatment at all. The Patient Access to Treatments Act eliminates excessive cost sharing that imposes heavy financial burdens and barriers to life-saving treatments.”

Health insurance plans have traditionally charged fixed co-pays for different tiers of medications. Each tier has a set co-pay. However, some health insurance policies are moving vital medications into specialty tiers that utilize high patient cost-sharing methods or co-insurance. When a medication is placed in a specialty tier, a patient is required to pay a percentage of the cost of the medication—sometimes more than 30 percent—rather than a fixed co-payment amount. Millions of Americans are unable to access life-saving treatments because of the financial burdens imposed by this practice. 

The Patient Access to Treatments Act of 2015 ends the practice of discriminating between medications with a fixed co-pay and so-called “specialty drugs” by requiring commercial health insurers to impose the same co-payment obligations for specialty drugs as they do for Tier III medications (non-preferred brand-name). 

The Patient Access to Treatments Act of 2015 is supported by the Coalition for Accessible Treatments.