Madison, WI – Today, State Rep. Paul Tittl (R-Manitowoc) reintroduced a bill relating to the application of prescription drug payments for health coverage. The bill ensures Wisconsin health plans and pharmacy benefit managers count copay assistance towards patient cost-sharing requirements. Already 16 states and Puerto Rico have enacted this policy.
“When people face a serious financial situation or deal with chronic disease, their primary concern is doing what they can to address that health concern to able to live as productively as possible,” said Rep. Tittl. “However, another major concern is often how to afford the necessary prescription medication.”
“More than 35 national and Wisconsin-based patient, provider organizations that make up the Wisconsin All Copays Count Coalition called on my colleagues today to cosponsor this bipartisan bill that would help Wisconsin patients access and adhere to their prescription medications,” said Rep. Tittl.
In recent years, insurers have shifted costs to insureds through coinsurance and high deductible health plans. Additionally, health insurance policies known as “copay accumulators” prevent the value of copay assistance from counting toward a patient’s annual deductible or out-of-pocket cost sharing requirements.
“Copay accumulators prevent copay assistance from helping patients pay down their deductibles,” added Rep. Tittl. “Patients are blindsided when they realize that drug coupons have not applied to their deductible. When the copay assistance runs out, a patient is faced with a tough decision: pay the full cost of their medication or walk away from the pharmacy counter empty-handed.”
A 2023 report from the AIDS Institute found that 8 out of 13 health plans in Wisconsin are implementing co-pay accumulator polices.
“Most patients who rely on copay assistance do not have access to generic alternatives for their condition,” Rep. Tittl said. “Faced with higher out-of-pocket costs, many patients end up rationing their medication or abandoning treatment altogether. This is about patient access to treatment”, said Rep. Tittl.
In the last legislative session, Rep. Tittl introduced the bill, and it received a hearing in the Assembly Committee on Health. To date eighteen bipartisan members have signed on as co-sponsors.
The 25th Assembly District includes portions of Calumet and Manitowoc Counties.
