Sending Office: Honorable Kevin Cramer
As the cost of prescription medications continues to make headlines, many of our nation’s sickest patients are only able to afford the life-saving medications they need because charities provide them with premium and cost-sharing assistance. A new
study by Avalere Health economists has shown that another benefit of charitable assistance is a reduction in total Medicare costs, which occurs through reduced medical spending.
According to the report, the patient assistance provided by just one charity organization saved Medicare $146 million between 2013 and 2017, or $0.48 million for every $1 million of patient assistance. In addition, this assistance reduced patient out-of-pocket
costs for medication, improved access to needed therapies, and enhanced medication adherence.
Despite the positive human and economic impact of patient assistance, these lines of support are now threatened. The Centers for Medicare and Medicaid Services (CMS) issued a federal policy that allows marketplace health plans to deny coverage to patients
with chronic and rare diseases if they receive charity assistance. A foreseeable result is more patients forced to enroll in government programs to cover the costs of their rising premiums and other essential health care – coverage that will ultimately fall
on our taxpayers. Perhaps most alarming is that health plans have expanded upon this marketplace regulation to include prohibitions on charitable assistance for Medicare Supplemental (Medigap) as well as other individual plans.
Charities are one of the cornerstones to the foundation of the American spirit, and it is up to us to protect their work. The
Access to Marketplace Insurance Act (H.R. 3976), a commonsense bill that already has more than 160 bipartisan cosponsors, will reverse these harmful outcomes.
This bill will ensure that America’s most vulnerable patients get the care they need while driving down federal health care spending.
Please consider joining H.R. 3976 as a cosponsor and support non-profits as the backbone of the health safety net for our fellow Americans. Contact Bree Vculek in my office at Bree.Vculek@mail.house.gov or call 5-2611 for additional information and to be
added as a cosponsor.
Member of Congress
e-Dear Colleague version 2.0