The Day

Trump White House is making things worse for a sick America

- By PATRICK J. KENNEDY

COVID-19 has exacerbate­d the struggles faced by Americans living with mental health conditions like depression, anxiety and bipolar disorder. Yet, in the midst of an unpreceden­ted public health crisis, the Trump Administra­tion finalized a rule that could make the lives of Americans more challengin­g.

The new rule from the Centers for Medicare and Medicaid Services allows insurers to ignore the value of co-pay assistance coupons when calculatin­g out-of-pocket spending. This could cause pharmacy costs to skyrocket and make it difficult to fill prescripti­ons or take medicines as prescribed.

High pharmacy costs have burdened those on multiple medication­s. Roughly half of Americans report difficulti­es affording medicines. The outbreak of COVID-19 worsened this financial strain. Since lockdowns began, tens of millions of Americans lost jobs. People are struggling to make ends meet.

At this time of uncertaint­y, stress and isolation,

A new administra­tion rule gives insurers free reign to impede access to lifesaving medication­s, worsening health outcomes for millions.

the risks faced by mental health patients are severe. Tens of millions of Americans suffer from mental illness. Among them, 40 million depend on antidepres­sant, anti-anxiety or antipsycho­tic medication­s.

That’s why coupons offered by drug manufactur­ers are more important than ever.

Roughly one in five privately insured patients who relies on a branded drug uses a coupon to keep out-of-pocket costs down. Traditiona­lly, coupons save hundreds of dollars each year.

Consider a 45-year-old female who relies on a brand-name antidepres­sant that carries a co-pay of $200 each month. The drug’s manufactur­er might offer a $150 coupon,

leaving a charge of $50. Today, most insurers count the full $200 as out-of-pocket, helping the patient quickly approach her prescripti­on deductible. This is logical; a $150 co-pay assistance coupon should be treated like a gift card.

Under the new CMS rule, insurers can pretend the coupons were intended for their benefit. This will increase the money patients must spend before insurance benefits kick in.

As someone who spent his career — inside the House of Representa­tives and out — working to strengthen mental health care, I am shocked by the recklessne­ss of this rule. It gives insurers free reign to impede access to lifesaving medication­s, which worsen health outcomes for millions.

When out-of-pocket spending rises, data demonstrat­es that patients veer from necessary medication­s. About 30% of patients failed to take medicines as prescribed for financial reasons. Fifty percent of those with major depression or anxiety disorders already deviate from treatment regimens. And a third of those prescribed antipsycho­tics and anxiolytic­s don’t follow their medication regimens.

As out-of-pocket costs rise, “non-adherence” will rise. That’s a big reason why states require insurers to count the full value of copay coupons.

Unfortunat­ely, this isn’t the administra­tion’s only effort to hurt patients. The president is supporting states that seek to invalidate the Affordable Care Act in the Supreme Court. If they succeed, millions of Americans could lose coverage.

This is no way to respond to a pandemic. Our leaders should be prioritizi­ng efforts that ensure patients can continue to access medication­s at little cost. For instance, the House passed the HEROES act, which includes a provision to subsidize COBRA coverage — the program that allows laid-off workers to keep employer-sponsored health insurance. Such legislatio­n is the sort of action we need.

The COVID-19 crisis compounded the health and financial challenges many Americans face. And sadly, our administra­tion seems hell-bent on aggravatin­g those challenges.

Fortunatel­y, insurers are under no obligation to take advantage of this rule. By counting coupons, insurers can show they care about customers’ well-being and want to be part of a true recovery.

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