On behalf of the undersigned organizations, we are requesting you join your colleagues Representatives Barragán, Cárdenas, Matsui, Panetta, Peters, and Sherman in their efforts to reduce patient costs by co-sponsoring and urging the passage of the Help Ensure Lower Patient (HELP) Copays Act (H.R. 830). H.R. 830 requires health insurance plans to count the value of copay assistance toward patient cost-sharing requirements, which would ensure that all payments, whether they come directly out of a patient’s pocket or with the help of copay assistance, count toward their out-of-pocket costs.

The undersigned organizations represent nonprofits, patient advocacy groups, and provider organizations serving billions of people living with serious, complex, chronic illnesses. We championed similar legislation in California – AB 874 (Weber) – because we believe all patients should access the medications they need without delays, disruptions, or surprise costs.

The HELP Copays Act is a two-part solution that will remove the ability for health plans to undermine coverage and restrict patient access. By prohibiting the use of copay accumulator adjustment programs, which remove the ability for patients to count copay assistance toward their annual deductible or out-of-pocket maximum, we can save patients from unexpected costs of thousands of dollars each month. A recent survey found that 69% of those who depend on copay assistance programs make less than $40,000 a year – if Congress doesn’t act now, these patients are at risk.

In addition to reinstating copay assistance, the HELP Copays Act closes the EHB loophole under the Affordable Care Act, which has allowed many employer health plans to deem certain categories of prescription medications as “non-essential,” even when they are life-saving or necessary for people with pre-existing and chronic conditions. By closing this loophole, H.R. 830 will protect patients from paying hundreds or thousands of dollars for medicines without ever hitting their out-of-pocket maximum.

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