HR0516 102ND GENERAL ASSEMBLY

HR0516 LRB102 21089 MST 30057 r

HOUSE RESOLUTION

WHEREAS, Forty-five percent of Americans have used a prescription drug in the past 30 days in the United States; and

WHEREAS, Millions of Americans rely on copay assistance programs to afford their prescription drugs; and

WHEREAS, On average, cost-sharing assistance helped patients taking HIV or oncology medicines with more than $1,600 toward their out-of-pocket cost in 2019 and helped patients taking multiple sclerosis medicines with more than $2,200; and

WHEREAS, When copay accumulator adjustment programs prevent any copayment assistance from counting toward a member's deductible or maximum out-of-pocket requirements, the result is that patients may be left with insurmountably high out-of-pocket expenses for their medications; and

WHEREAS, Patients with chronic and rare diseases are particularly impacted and struggle to afford their specialty medications; and

WHEREAS, Copay accumulator adjustment programs coupled with the rise of patient out-of-pocket expenses resulting from increased deductibles and co-insurance, accounting for up to 95 percent of patients costs for brand medicines, leads to patient medication nonadherence; and

WHEREAS, Medication nonadherence has led to between $100 and $300 billion of avoidable health care costs in the United States annually, due to avoidable hospitalizations and medical visits; and

WHEREAS, The State of Illinois passed Public Act 101-0452 (215 ILCS 134/30(d)) to eliminate the burden patients face due to copay accumulator programs; and

WHEREAS, Public Act 101-0452 passed the Illinois General Assembly with unanimous support; and

WHEREAS, The law ensures that a health care plan shall apply any third-party payments, financial assistance, discount, product vouchers, or any other reduction in out-of-pocket expenses made by or on behalf of such insured for prescription drugs toward a covered individual's deductible, copay, or cost-sharing responsibility or out-of-pocket maximum associated with the individual's health insurance; and

WHEREAS, The lack of clarity between federal and state laws and regulations has left consumers in a vulnerable position; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE HUNDRED SECOND GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we declare our commitment to ensuring access to quality health care for patients and healthcare consumers in Illinois; and be it further

RESOLVED, That we urge the Illinois Congressional Delegation to support federal legislation to ensure all copays count and urge the federal regulators to specifically clarify that all copays count in the 2023 Notice of Benefit and Payment Parameters and tri-agency guidance; and be it further

RESOLVED, That suitable copies of this resolution be delivered to the Governor, the Director of the Illinois Department of Insurance, all Illinois constitutional officers, and all members of the Illinois Congressional Delegation in order to bring further awareness to the importance of access to healthcare for our residents of the State of Illinois and to be a model state for the rest of the country.