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Letter to Missouri House Health Committee supporting HB1941 to ban copay accumulators

Feb 3, 2026

We strongly support House Bill 1941 which ensures that health insurers accept and count payments made on behalf of patients toward their deductibles and out-of-pocket maximums. Copay accumulators are harmful policies increasingly implemented by insurers, employers, and pharmacy benefit managers (PBMs). Under these policies, copay assistance provided by drug manufacturers does not count toward patients’ cost-sharing obligations, such as deductibles and out-of-pocket maximums. While patients can initially use the assistance to afford their medications, they often face unexpected and substantial costs later in the year when the assistance runs out, leaving them unable to pay for their prescriptions.

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Comments on Oregon PDAB draft 2026 drug review preliminary list

Jan 16, 2026

Affordability reviews of HIV medications are unlikely to fully capture the complexity and interdependence of safety net programs, which not only ensure affordability for patients but also sustain the broader HIV care infrastructure. While we recognize the Board’s current position to not seek upper payment limit authority, reviewing medications like Biktarvy, Descovy, and Emtricitabine-Tenofovir based on list price alone (despite their actual affordability for the vast majority of patients) could have significant unintended consequences. Such reviews risk creating systemic uncertainty for manufacturers, healthcare providers, and safety net programs that rely heavily on drug rebates to fund essential wraparound services. Ultimately, this instability could undermine the delicate balance required for continued investment in the transformative advancements our community relies on, including longer-acting treatments, preventive therapies, vaccines, and the pursuit of an eventual cure.

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Arkansas Medicaid community engagement reporting requirement and people with HIV

Jan 15, 2026

We write to urge the Arkansas Medicaid program to include an explicit exemption for all people living with HIV from the community engagement reporting required under HR 1. People with HIV are living with a lifelong serious and complex medical condition and have special medical needs: they cannot stay healthy without continuous access to their lifesaving HIV treatment.  Any gap in treatment risks serious health consequences, including failure of viral suppression and the risk of onward transmission.  Longer treatment gaps are potentially disabling, allowing progression to AIDS, after which life expectancy is limited.

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Nebraska Medicaid community engagement reporting requirement and people with HIV

Jan 15, 2026

We write to urge the Nebraska Medicaid program to include an explicit exemption for all people living with HIV from the community engagement reporting required under HR 1. On May 1, Nebraska intends to become the first state in the nation to implement the new community engagement requirements. People with HIV are living with a lifelong serious and complex medical condition and have special medical needs: they cannot stay healthy without continuous access to their lifesaving HIV treatment.  Any gap in treatment risks serious health consequences, including failure of viral suppression and the risk of onward transmission.

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