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Rep. David Cannon introduces RS32580 to replace HB219 on copay-accumulator rules
Summary
Representative David Cannon introduced RS32580, a rewrite of earlier House Bill 219, intended to treat third-party payments to medication costs as counting toward patients' copays and out-of-pocket maximums while sharing cost impacts with drug manufacturers.
Representative David Cannon, R-Blackfoot, introduced RS32580 to the House Health and Welfare Committee as a replacement for the earlier House Bill 219 addressing so-called "copay accumulator" practices.
Cannon told the committee he first raised the matter after meeting the family of Emerson Drolinger, a high-school student in his district with cystic fibrosis. He described copay accumulator programs as an insurance practice "whereby third party payments that go toward medications for a patient are not credited to the patient for purposes of copays and or out of pocket maximum payment." Cannon said that practice appears "unfortunate and unfair" to patients and families.
RS32580 keeps the central consumer benefit of applying third-party payments toward patients' copay and out-of-pocket maximums, Cannon said, but alters cost-sharing compared with HB219. "The changes that we've made also kinda shares that cost not only with the insurance company but with the pharmaceutical company that is typically the third party that is helping with these medical payments," Cannon said, adding the change should reduce the financial impact on insurers and, therefore, potential premium increases.
Cannon asked the committee to introduce the RS. The committee made a motion to introduce RS32580 and approved it by voice vote; the transcript records a voice "aye" and the chair declared the motion passed and RS32580 introduced. No further details on committee debate, fiscal estimates, or scheduled hearings were recorded in the transcript.
The transcript indicates this RS is intended as a replacement for House Bill 219; Cannon said he had met with stakeholders and made tweaks to the proposal since the earlier bill's introduction.
