February 9, 2023

The Honorable Earl L. Carter (R-GA)
U.S. House of Representatives
Washington, DC 20515

Rep. Yvette Clarke (D-NY)
U.S. House of Representatives
Washington, DC 20515

Rep. Bonnie Watson Coleman (D-NJ)
U.S. House of Representatives
Washington, DC 20515

Rep. Diana DeGette (D-CO)
U.S. House of Representatives
Washington, DC 20515

The Honorable Nanette Barragán (D-CA)
U.S. House of Representatives
Washington, DC 20515

Rep. Brian Fitzpatrick (R-PA)
U.S. House of Representatives
Washington, DC 20515

Rep. Mariannette Miller-Meeks (R-IA)
U.S. House of Representatives
Washington, DC 20515

Dear Representatives Carter, Barragán, Clarke, Coleman, DeGette, Fitzpatrick, and Miller-Meeks:

The All Copays Count Coalition (ACCC), on behalf of the 75 undersigned organizations, expresses sincere thanks for your leadership in introducing H.R. 830, the Help Ensure Lower Patient Copays Act (HELP Copays Act). We pledge to work with you to ensure that this common-sense, bipartisan legislation becomes law. The ACCC represents the interests of individuals living with serious, chronic health conditions for whom ongoing and continuous access to treatment is essential. And yet, these individuals often face multiple barriers to the therapies they need to treat their conditions, such as prior authorization and step therapy that limit or delay access to specialty medications. And once approved, patients often face skyrocketing deductibles and steep cost-sharing requirements. With no other options to afford the medicine they need, many patients turn to charitable or manufacturer copay assistance to afford their drugs. Unfortunately, many insurers are taking this assistance intended for patients and not counting it towards a patient’s deductible and out-of-pocket maximum. This it yet another barrier for patients and can result in unexpected bills that could reach into the thousands of dollars. Unfortunately, this has all too often resulted in patients not being able to access their medications, and the number of heartbreaking stories is only growing.

We applaud this piece of legislation because it is a two-part solution that eliminates barriers to treatment for some of the most vulnerable Americans—those who live with serious, complex chronic illness—ensuring that they can afford the necessary and often life-saving medications prescribed by their providers. Specifically, the bipartisan HELP Copays Act:

• Requires health plans to count the value of copay assistance toward patient cost-sharing requirements. This would bring much-needed relief to financially vulnerable individuals by ensuring that all payments—whether they come directly out of a patient’s pocket or with the help of copay assistance—count towards their out-of-pocket costs.
• Ends a practice by which many employer health plans deem certain covered drugs as “nonessential,” which means that the insurer will not count any cost-sharing toward the patient’s deductible and out-of-pocket maximum. Your bill will require all private plans to count all cost-sharing for covered services to accrue to a patient’s deductible and out-of-pocket maximum.

Together, these practices undermine coverage for pre-existing conditions, hurt patient access to necessary medications, decrease drug adherence, and even cost our health care system more money. We pledge to work with you to ensure that the HELP Copays Act becomes law, and these harmful practices end once and for all.


All Copays Count Coalition Steering Committee
Arthritis Foundation
Cancer Support Community
Immune Deficiency Foundation
National Hemophilia Foundation
National Multiple Sclerosis Society
The AIDS Institute

Member Organizations
2 For 2 Boobs, Inc.
Accessia Health
AIDS Foundation Chicago
Aimed Alliance
Alliance for Patient Access
ALS Association
American Kidney Fund
Association for Clinical Oncology
Cervivor, Inc.
Chronic Care Policy Alliance
CLL Society, Inc.
Coalition of Skin Diseases
Coalition of State Rheumatology Organizations
Community Oncology Alliance (COA)
Crohn’s & Colitis Foundation
Cystic Fibrosis Research Institute
Derma Care Action Network
Diabetes Leadership Council
Diabetes Patient Advocacy Coalition
Digestive Disease National Coalition
Dystonia Advocacy Network
Dystonia Medical Research Foundation
Eastern PA Bleeding Disorders Foundation
Epilepsy Foundation
EveryLife Foundation for Rare Diseases
FORCE: Facing Our Risk of Cancer Empowered
Foundation for Sarcoidosis Research
Georgia AIDS Coalition
Global Healthy Living Foundation
Haystack Project
Hemophilia Alliance
Hemophilia Council of California
Hemophilia Federation of America
HIV + Hepatitis Policy Institute
HIV Medicine Association
Hope Charities
ICAN, International Cancer Advocacy Network
Infusion Access Foundation (IAF)
International Foundation for Gastrointestinal
International Myeloma Foundation
Looms For Lupus
LUNGevity Foundation
Lupus and Allied Diseases Association, Inc.
Lupus Foundation of America
National Alopecia Areata Foundation
National Consumers League
National Eczema Association
National Infusion Center Association (NICA)
National Organization for Rare Disorders
National Pancreas Foundation
National Psoriasis Foundation
National Scleroderma Foundation
NephCure Kidney International
Ovarian Cancer Research Alliance
Patient Access Network (PAN) Foundation
Patient Empowerment Network
Platelet Disorder Support Association
Project Sleep
Pulmonary Hypertension Association
Ryan White Medical Providers Coalition
Society of Dermatology Physician Assistants (SDPA)
Susan G. Komen
Triage Cancer
US Hereditary Angioedema Association
wAIHA Warriors