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Committee hears bill to count co‑pay assistance toward patients’ deductibles

House Committee on Health and Human Services · May 1, 2025
AI-Generated Content: All content on this page was generated by AI to highlight key points from the meeting. For complete details and context, we recommend watching the full video. so we can fix them.

Summary

House Bill 6209 would require insurers to count third‑party co‑pay assistance toward patients’ deductibles or out‑of‑pocket maximums in situations with no generic alternative or after utilization steps. Patient advocates urged passage, while insurers warned of manufacturer incentives and premium impacts.

Representative Furtado introduced House Bill 6209 to require that payments made on a patient's behalf—whether by manufacturers, nonprofits or other third parties—be counted toward a patient's deductible or maximum out‑of‑pocket if no generic alternative exists or after required prior authorization/step therapy.

Paul Adam, a volunteer with the American Cancer Society Cancer Action Network, described personal financial harm from accumulator adjustment programs…

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