AHIP Testimony: ‘Cap The Copay’ Legislation A ‘Shell Game’ Run On Consumers

posted by Clare Krusing

on March 16, 2015

For Immediate Release

Health Plans Support Drugmaker “Transparency” Bill to Provide Data on
Drug Production, Marketing Costs  

Salem, OR – The Oregon State Legislature is considering legislation that would cap co-payments on specialty medications – an effort that amounts to drug companies playing a “shell game” on consumers. Such proposals obscure drugmakers’ role in the unsustainable cost of health care, according to Leanne Gassaway, Vice President of State Affairs for America’s Health Insurance Plans (AHIP), who testified today before the House Committee on Health Care.

“Limiting co-payments does nothing to address the high cost of prescription drugs. Instead, such proposals seek to allow pharmaceutical manufacturers to continue to have a blank check to charge whatever they want for their medications,” Gassaway said in her testimony.

House Bill 2951 requires health insurance products that include prescription drug coverage to meet specified cost-sharing requirements.  The bill would limit co-payments on prescription drugs in all health insurance products at $100 for a 30-day supply, as well as prohibiting deductibles for drug coverage.

According to Gassaway, imposing limits on prescription drug coverage without addressing one of major drivers of higher costs for patients – the high price of the actual drug – would drive up premiums for consumers and employers.

Health Plans Point to Transparency Legislation

While proposals to include caps on prescription drug coverage amount to a short-term shell game on consumers, transparency in prescription drug pricing would be an important step toward affordability and sustainability for consumers and employers, according to Gassaway, who offered testimony in support of House Bill 3486. Currently, drugmakers do not have to disclose how they developed the prices for their medications, leaving stakeholders in the dark when it comes to the prices being charged.

“This unsustainable approach in the pricing of life saving medications threatens the viability of public health programs, like the Oregon Health Plan, the state employee plans under OEBB and PEBB, employer and family coverage, and the health care system as a whole,” Gassaway testified. “Transparency will increase competition in the market and help drive down costs for patients and the health care system overall.”


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