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Ohio bill seeks to prohibit health insurance cost-sharing policies known as copay accumulators

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A coalition of patient advocacy groups and health care provider organizations are pushing for passage of an Ohio bill that would reform health insurers' copay policies.


House Bill 177 specifically targets copay accumulator policies, which determine how — or if — copay coupons from drug manufacturers get applied to patient deductibles.


Some health plans restrict those coupons from counting toward a patient's out-of-pocket maximum payments.


House Bill 177 would direct health insurers to count those coupons toward a patient's out-of-pocket costs for medicines used for chronic or life-threatening diseases — a change that insurance companies argue could result in higher premiums.


On Cincinnati Edition, we discuss the complex issue of copay accumulators, drug prices and the impact on patients.

Guests:

  • State Rep. Susan Manchester, representing Ohio's 78th district

  • Alique Topalian, Ph.D., two-time acute myeloid leukemia survivor and a researcher in survivorship and support services at a major cancer center

  • Johnny Garcia, pharmacist and senior director of policy, Pharmaceutical Care Management Association

  • Nick McGee, deputy vice president of public affairs, Pharmaceutical Research and Manufacturers of America


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