Illinois General Assembly - Full Text of HR0516
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Full Text of HR0516  102nd General Assembly

HR0516 102ND GENERAL ASSEMBLY


  

 


 
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1
HOUSE RESOLUTION

 
2    WHEREAS, Forty-five percent of Americans have used a
3prescription drug in the past 30 days in the United States; and
 
4    WHEREAS, Millions of Americans rely on copay assistance
5programs to afford their prescription drugs; and
 
6    WHEREAS, On average, cost-sharing assistance helped
7patients taking HIV or oncology medicines with more than
8$1,600 toward their out-of-pocket cost in 2019 and helped
9patients taking multiple sclerosis medicines with more than
10$2,200; and
 
11    WHEREAS, When copay accumulator adjustment programs
12prevent any copayment assistance from counting toward a
13member's deductible or maximum out-of-pocket requirements, the
14result is that patients may be left with insurmountably high
15out-of-pocket expenses for their medications; and
 
16    WHEREAS, Patients with chronic and rare diseases are
17particularly impacted and struggle to afford their specialty
18medications; and
 
19    WHEREAS, Copay accumulator adjustment programs coupled
20with the rise of patient out-of-pocket expenses resulting from

 

 

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1increased deductibles and co-insurance, accounting for up to
295 percent of patients costs for brand medicines, leads to
3patient medication nonadherence; and
 
4    WHEREAS, Medication nonadherence has led to between $100
5and $300 billion of avoidable health care costs in the United
6States annually, due to avoidable hospitalizations and medical
7visits; and
 
8    WHEREAS, The State of Illinois passed Public Act 101-0452
9(215 ILCS 134/30(d)) to eliminate the burden patients face due
10to copay accumulator programs; and
 
11    WHEREAS, Public Act 101-0452 passed the Illinois General
12Assembly with unanimous support; and
 
13    WHEREAS, The law ensures that a health care plan shall
14apply any third-party payments, financial assistance,
15discount, product vouchers, or any other reduction in
16out-of-pocket expenses made by or on behalf of such insured
17for prescription drugs toward a covered individual's
18deductible, copay, or cost-sharing responsibility or
19out-of-pocket maximum associated with the individual's health
20insurance; and
 
21    WHEREAS, The lack of clarity between federal and state

 

 

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1laws and regulations has left consumers in a vulnerable
2position; therefore, be it
 
3    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE ONE
4HUNDRED SECOND GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
5we declare our commitment to ensuring access to quality health
6care for patients and healthcare consumers in Illinois; and be
7it further
 
8    RESOLVED, That we urge the Illinois Congressional
9Delegation to support federal legislation to ensure all copays
10count and urge the federal regulators to specifically clarify
11that all copays count in the 2023 Notice of Benefit and Payment
12Parameters and tri-agency guidance; and be it further
 
13    RESOLVED, That suitable copies of this resolution be
14delivered to the Governor, the Director of the Illinois
15Department of Insurance, all Illinois constitutional officers,
16and all members of the Illinois Congressional Delegation in
17order to bring further awareness to the importance of access
18to healthcare for our residents of the State of Illinois and to
19be a model state for the rest of the country.