November 29, 2021

Dear Congressman McEachin and Congressman Davis,

We are writing to express our sincere thanks to you for your leadership in introducing HR 5801, the Help Ensure Lower Patient Copays Act (HELP Copays Act) and pledge to work with you to ensure that this common-sense, bipartisan legislation becomes law.

People living with serious, chronic health conditions often face multiple barriers to the therapies they need to treat their conditions, such as administrative hurdles like prior authorization and step therapy that limit 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. But now, they are faced with an additional barrier and unexpected bills that could reach in the thousands of dollars because their insurance plan will not count the copay assistance they get toward their annual deductible or out-of-pocket maximum.

We applaud your 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 doctors:

• 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.
• Your legislation also closes a loophole that allows many employer health plans to deem certain covered drugs as “non-essential,” 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 medicines, 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.

Sincerely,

National Organizations
AIDS Alliance for Women, Infants, Children, Youth & Families
Aimed Alliance
Alliance for Balanced Pain Management
Alliance for Patient Access
Alpha–1 Foundation
American Academy of HIV Medicine
American Liver Foundation
American Medical Association
American Society of Hematology
Arthritis Foundation
Association for Clinical Oncology
Association of Asian Pacific Community Health Organizations (AAPCHO)
Association of Women in Rheumatology
Autoimmune Association
Cancer Support Community
CancerCare
Caregiver Action Network
Center for Health Law and Policy Innovation
Chronic Care Policy Alliance
Clinical Neurological Society of America
Coalition of State Rheumatology Organizations
Community Liver Alliance
Crohn’s & Colitis Foundation
Derma Care Access Network
Diabetes Leadership Council
Diabetes Patient Advocacy Coalition
Digestive Disease National Coalition
Dystonia Medical Research Foundation
Epilepsy Foundation
FORCE – Facing Our Risk of Cancer Empowered
GBS|CIDP Foundation International
Haystack Project
Hemophilia Alliance
Hemophilia Federation of America
Hepatitis B Foundation
Hepatitis B Foundation and Hep B United
HIV + Hepatitis Policy Institute
HIV Medicine Association
Huntington’s Disease Society of America
Immune Deficiency Foundation
International Foundation for Gastrointestinal Disorders
International Myeloma Foundation
Interstitial Cystitis Association
Lupus and Allied Diseases Association, Inc.
Lupus Foundation of America
Lymphatic Education & Research Network
METAvivor
Movement Disorders Policy Coalition
Multiple Sclerosis Association of America
NASTAD
National Alopecia Areata Foundation
National Consumers League (NCL)