Colorado, Texas Pass Legislation to Limit the Use of Copay Accumulators
In the past week, both Colorado and Texas took major steps towards protecting the ability of people with lupus in their states to access affordable prescription medications by signing into law legislation that limits the use of copay accumulator programs.
The Lupus Foundation of America has been a leading supporter of legislation to ban copay accumulators, which are insurance company policies that prevent third-party financial assistance from counting towards a patient’s annual cost-sharing requirements, including their deductible and out-of-pocket maximums. These policies increase patient costs and limit access to needed care.
In Colorado, SB23-195 was passed by their legislature and signed into law by Governor Jared Polis on June 6. Texas Governor Greg Abbott signed into law HB 999 on June 10 after it was previously passed by their legislature.
While the exact language in each state’s legislation differs, the effect on people with lupus and other chronic conditions in Colorado and Texas will be the same – ensuring that financial assistance available to people with lupus will lower their drug costs and can be used to satisfy their deductible and other cost-sharing requirements.
Many people with lupus rely on third-party financial assistance to afford medications prescribed by their doctors. Whether the financial assistance comes from a pharmaceutical company or a charitable organization, this assistance is critical and helps people access the medications they need to improve their health and quality of life.
The new laws in Colorado and Texas both require that when insurance companies calculate cost-sharing requirements, they include the value of the financial assistance a patient has received. Previously, insurance companies were able to disregard the value of that assistance which frequently left patients responsible for their entire deductible despite the money that had already been paid to their insurance company on their behalf.
To learn more about copay accumulator programs and how they impact people with lupus, please read our Policy Spotlight on the issue.
Foundation Advocacy in Support of SB23-195 and HB 999
The Lupus Foundation of America worked closely with the Chronic Care Collaborative in Colorado and the All Copays Count Coalition in each state to ensure these critical pieces of legislation were passed and signed into law, including participating in advocacy campaigns urging the Colorado and Texas legislatures and both Governor Polis and Governor Abbott to enact laws that limit the use of copay accumulators. This campaign, which included outreach from the Foundation, our coalition partners and testimony of patients in Colorado and Texas, helped to advance the bills through the legislative process.
The Foundation would like to thank Governors Polis and Abbott and the sponsors of the legislation for their tireless work in pursuit of savings for patients in their states – Senators Faith Winter and Perry Will and Representatives Iman Jodeh and Rose Pugliese in Colorado, and Senator Charles Schwertner and Representatives Steve Allison, Ryan Guillen, Tom Oliverson and Four Price in Texas.
The Lupus Foundation of America recognizes and commends both Colorado and Texas for their bipartisan efforts that take big steps forward in our mission to protect patients with lupus around the country!
To be a part of the next success story in your state, sign up as an advocate!