Michigan Advocacy Update
Sarah Procario, Advocacy Director, Hemophilia Foundation of Michigan
As chair of the Michigan All Copays Count Coalition (MACC), HFM advocacy efforts continue to focus on passing House Bill 4353, copay accumulator reform legislation that will ensure all copayments count towards a patient’s deductible and out-of-pocket costs. After passing the House with an overwhelming bipartisan majority in March 2021, the bill moved to the Senate House Health Policy and Human Services Committee where it has unfortunately been sitting for over a year without movement.
MACC has been focused on outreach to Chair Vanderwall and the full Senate to push for a hearing as soon as possible.
Ohio Advocacy Update
Randi Clites, State Policy Director, Ohio Bleeding Disorder Council
Emerging trends in ERISA health plan design may threaten care for people with bleeding disorders. ERISA plans are exempt from the ACA’s mandated coverage of prescription drugs and other “Essential Health Benefits.” Drug benefits middlemen, exploiting this EHB loophole, are selling plan sponsors on schemes that promise to lower plan spending on specialty drugs. One approach forces health plan enrollees into “copay maximizer programs:” under this approach, the health plan captures all available manufacturer copay assistance while crediting NONE of that money toward the patients’ cost-sharing. Another approach steers patients into drug manufacturer product programs that are supposed to serve as limited bridge programs. This fall, it will be critically important to educate patients about these dangerous practices and encourage patients to carefully read their plan documents.