Proposed Legislation Would Ensure Co-pays Apply to Health Insurance Deductibles

Jan 22, 2020

Some Ohioans who rely on copay assistance programs to help with expensive medications are finding that their insurance companies are no longer allowing those payments to apply to their deductibles. Two lawmakers are hoping their bill will stop that.

The situation hits people with chronic and complex illnesses very hard, because their meds cost tens of thousands of dollars and there’s usually no generic equivalent.  State Rep. Randi Clites (D-Ravenna) has a son with hemophilia. She isn’t a sponsor, but supports the bill.

“This does disproportionately impact those who are high cost and rare diseases, but this will impact all patient groups who have any copay assistance.”

The bill's sponsors include State Rep. Thomas West (D-Canton) and State Rep. Susan Manchester (R-Waynesfield). They say insurers can take the assistance payment and also the patient’s copays – so insurers are essentially getting paid twice for the same drugs. Their bill would require insurance companies to allow copay assistance payments to apply to patient deductibles, which they say would lower patients’ out of pocket costs.