Patients in Ohio could gain an important protection from higher out-of-pocket insurance costs.

State Representative Susan Manchester, R-Waynesfield, has teamed up with State Representative Thomas West, D-Canton, to author health care reform legislation that will protect Ohio patients that receive financial support from copay assistance programs.

“The rising cost of prescription drugs is one of the greatest challenges we currently face,” Rep. Thomas West said. “House Bill 469 is a critical step towards reversing that trend by ending these unfair practices and ensuring greater access to the lifesaving drugs Ohioans desperately need.”

Ohio House Bill 469 comes in response to insurance companies that have employed controversial schemes that block patients from accessing drug discounts, or blindside patients with higher out-of-pocket costs when they go to refill their prescriptions.

Co-Pay Assistance Programs Deliver Critical Support to Patients

Copay assistance programs lower patients’ real out-of-pocket costs by allowing a church, charity, or even pharmaceutical manufacturer to cover a portion of the patient’s co-pay. Every year, co-pay assistance programs provide billions of dollars of critical financial support to patients in need.

“When insurance companies and pharmacy benefit managers block access, patient assistance programs step in and provide patients with a path to access life-saving treatment,” explains Terry Wilcox, executive director at Patients Rising, a national patient advocacy non-profit organization that helps patients facing insurance barriers.

One in five prescriptions are filled in the United States using copay coupons. More than half of rheumatoid arthritis access their treatments with the help of copay coupons, according to Stanford University research.

Insurance Companies Blindside Patients with Co-Pay Accumulator Programs

In recent years, insurance companies have developed a payment scheme that allows insurance companies to increase their profits from patients that use copay coupons. Copay accumulator programs block copay assistance or co-pay discounts from counting towards a patient’s annual insurance deductible.

“Copay accumulator programs increase a patient’s out-of-pocket costs,” points out Wilcox of Patients Rising. “They are especially devastating for patients living with rare and chronic diseases who need access to specialty drugs.”

Ohio House Bill 469 would prevent insurance companies from blindsiding patients with copay accumulator programs.

“These policies discriminate against patients with chronic conditions, as well as those who need innovative prescription drugs for which no generics typically exist,” said Rep. Manchester. “House Bill 469 fights to cut out-of-pocket prescription drug costs for our families.”

Get Involved: Support Ohio House Bill 469

  • Share on Social Media: Copay accumulators blindside patients with thousands of dollars in higher insurance costs because of unmet deductibles. Thank you Rep. Susan Manchester & Rep. Thomas West for protecting patients. #OH #HouseBill469
  • Share Your Story: Is your insurance company denying your co-pay coupon? Share your story with Patients Rising.
  • Become Patients Rising Advocate: Join Patients Rising and become a patient advocate.