Over the next few weeks, thousands will select insurance plans for 2022, whether on a state exchange or through their employer. A health plan’s fine print hardly makes for riveting reading. So most folks just focus on the monthly premium, make sure their doctor is covered, and ensure cost-sharing responsibilities are manageable. But that fine print is important, especially when it comes to how insurers treat co-pay assistance, or financial help that drug companies offer to patients to assist them with prescription drug out-of-pocket costs. [This opinion piece also appeared in The Lebanon Democrat, The Leader/Observer, Forest Hills/Rego Park Times, Long Island City/Astoria/Jackson Heights Journal, Greenpoint Star, and Brooklyn Downtown Star.]
As 2021 comes to a close, it is a good time to take a moment to reflect on the year and think about the challenges ahead. This year, we commemorated the 40th anniversary of the first cases of what would become known as AIDS, welcomed a budget proposal from President Biden that more than doubled the funding for the Ending the HIV Epidemic in the U.S. initiative and was fully supported by both the House and Senate. President Biden gave his full commitment to ending HIV during a White House World AIDS Day event and released an updated National HIV/AIDS Strategy for the U.S. 2022–2025. We in the HIV community have many reasons to be hopeful, and yet our work is far from done. We must come together as a community focused on ending the HIV epidemic in new and different ways.
We must make drugs more affordable: Patients going without meds can hike costs for the entire health care system
Falling ill in America is becoming increasingly unaffordable in a health care system that punishes the patient. Insurance companies and middlemen have taken away protections against health care discrimination and crushing out of pocket costs for people with complex and chronic conditions. Not only does this increase costs across the health care system, it also deters efforts to improve health equity and patient outcomes.
A health plan’s fine print hardly makes for riveting reading. So most folks just focus on the monthly premium, make sure their doctor is covered, and ensure cost-sharing responsibilities are manageable. But that fine print is important, especially when it comes to how insurers treat co-pay assistance — financial help that drug companies offer to patients to assist them with prescription drug out-of-pocket costs. Choosing a plan that doesn’t count co-pay assistance toward the deductible or out-of-pocket maximum could cost a person or family several thousand dollars per year in unexpected costs.
The leadership of the US Senate Appropriations Committee delivered welcome news recently to HIV and public health advocates with the release of their fiscal year 2022 spending bills. Like their colleagues in the House, the Senate has proposed significant funding increases to the Ending the HIV Epidemic in the U.S. initiative with at least $245 million more to focus on increased testing, prevention, treatment, and research programs. This matches the amount proposed in President Biden’s budget and approved by the House.