COPAY ACCUMULATORS HARM PATIENTS
Patients are being harmed by copay accumulator adjustment policies (CAAPs) that bar copay assistance from counting towards a patient’s deductible or out-of-pocket maximum. These policies take away support intended for patients and harm them by:
- Exposing vulnerable patients to large, unexpected costs: CAAPs disproportionately impact patients suffering from serious illness, particularly those who are low income or persons of color.
- Interrupting necessary treatment: Nearly all copay assistance is used to pay for medicines without generic alternatives. When more costs are transferred to the sick and vulnerable, those patients often lose access to needed medications—driving down drug adherence and resulting in other more costly health issues. CAAPs create an unnecessary barrier that interrupts the course of critical treatment for patients.
- Undermining patient protections: The Affordable Care Act provided minimum standards for coverage and protections against high out-of-pocket costs, particularly for those with pre-existing health conditions. CAAPs erode these protections and harm patients with serious chronic health conditions.
Insurers can continue to charge patients as if they have not been paid, driving higher profits, while patients go without necessary medications. This practice is so egregious that the Federal Employees Health Benefit Plan announced earlier this year that it would not accept any plan that employs it.
PATIENTS AND ADVOCATES SPEAK OUT
Learn more about the harmful impact of copay accumulators adjustment policies from patients with various health conditions, caregivers and patient groups working to help protect them: