Policy Change From HHS Puts The Health And Financial Security Of Millions At-Risk

Policy Change From HHS Puts The Health And Financial Security Of Millions At-Risk

In recent weeks, we have had more reasons to be cautiously optimistic about our national response to the coronavirus pandemic. Not only have hospitalizations and death counts in the hotbed area of the crisis, New York State, steadily declined, but the pharmaceutical industry has made significant progress toward both treatments and a vaccine for the virus.


To be sure, we still have a long way to go.


Beyond the healthcare elements of addressing this crisis, millions of Americans are contending with serious economic pain. Many of the best estimates predict that the economy will not recover to levels seen at the beginning of this year until at least 2022 or later.


It seems that in such times, American consumers need more predictability in their daily lives and policymakers should do everything they can to support a return to normalcy once the virus is in check.


At a high level, this has been successfully done with the CARES Act, which was supported by broad swaths of the public. In fact, it has been years since such a large policy passed on a bipartisan basis.


In a letter to Democratic colleagues, House Speaker Nancy Pelosi praised the bipartisan legislation as “a strong stimulus to our economy to protect the health and financial security of America’s working families as we fight the coronavirus crisis.” President Trump and Senate Majority Leader McConnell also applauded the legislation.


At a less public level however, policymakers are falling short. In particular, there are sweeping changes for prescription drugs underway which will significantly restrict patient affordable access to medicines despite many struggling in this pandemic.


Last week, the Centers for Medicare & Medicaid Services released their final Notice of Benefit and Payment Parameters (NBPP) rule for 2021. Starting next January, because of the  NBPP rule, millions of patients are likely to see an increase in out of pocket expenses tied to their brand name prescriptions.


In a reversal of policy from just one year ago, the Department of Health and Human Services (HHS) intends to allow health insurance companies to exclude the value of drug manufacturer cost-sharing assistance programs and coupons from counting toward the health plan member’s required annual limits on out-of-pocket expenses, regardless of whether generic drug is available.


Put simply, this change in policy from HHS would have serious negative effects on patients, their treatment regimens prescribed by their doctors, and their household budgets.


Even before the coronavirus pandemic became a widespread issue in the United States, Americans have demanded change in lowering costs related to healthcare and prescription drugs, either through the pass thru of rebates to the patient or through the increased access to the assistance offered by the drug manufacturers. According to a February poll conducted by Politico and the Harvard T.H. Chan School of Public Health, 80% of Americans believe it is very important or extremely important to take steps to lower the cost of health care and 75% believe it is important to lower prescription drug costs.


HHS’ change in policy could make it impossible for patients to receive and take their prescribed medicines at any time because insurance coverage for medicines is continually becoming less and less.


It would also have a seismic impact on the insurance market by undercutting the cost-saving benefits and availability of high-deductible insurance plans. These insurance plans are fundamental options in our current market and without them, millions more Americans could be uninsured.


Perhaps most importantly in these times of great economic uncertainty, HHS’s policy change could make the patient’s already rising out-of-pocket costs for prescription drugs skyrocket and would risk the financial security of millions of Americans.


Put another way, if the economic impact of the coronavirus pandemic isn’t straining at risk households enough already, HHS’ policy change could very well could put their health and financial security in ruin.


Now is not the time to make access to healthcare and prescription drugs unaffordable to Americans.





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