Priority: Pass the Patients' Access to Treatments Act
Drugs Are Being Placed Out of Patient Reach
Commercial health insurers have traditionally charged fixed co-pays for different tiers of medications. As an example, the co-pays might be set at $10/$20/$50 for the three tiers.
Some commercial health insurance policies are now moving vital medications (mostly biologics) into a fourth specialty tier. Specialty Tiers require patients to pay a percentage of their drug cost– from 25% to 50%– rather than a fixed co-payment. These practices are placing medically necessary treatments out of reach of average Americans.
- Biologics are FDA approved and have no inexpensive, generic equivalents.
- Biologics can prevent patients with rheumatoid arthritis, MS, lupus, hemophilia, and some forms of cancer, from becoming disabled, seriously ill, or even dying.
- Monthly co-insurance amounts often range from $500-$5,000. Cost-sharing for prescription medications restricts access to medically necessary drugs.
- Individuals unable to afford specialty tier pricing are likely to go without crucial medications, resulting in disability and other expensive health complications.
The bipartisan Patients’ Access to Treatments Act (H.R. 460), introduced by Rep. David McKinley (R-WV) and Rep. Lois Capps (D-CA), limits cost-sharing requirements in the specialty drug tier (typically Tier IV or higher) to a similar dollar amount applicable to drugs in a non-preferred brand drug tier (typically Tier III).
What You Can Do To Take Action on This Issue:
1.Read and Share:
The HR 460 issue brief with your member of Congress
- The HR 460 issue brief with your Senator
Read our press release on H.R. 460 - The Patients' Access to Treatments Act
- Read and share our study on H.R. 460 by Avalere.
2. Listen and Learn: Download a recorded issue-expert training on the Patients' Access to Treatments Act.
3. Take a quick survey to tell us how the cost of prescription drugs has made it difficult for you to afford treatment.
4. Call your Representative and using our call scripts below.
Sample Call Scripts:
To contact your legislator and request their support for H.R. 460, dial the Capitol Switchboard at (202) 224-3121. Once connected to the legislative office, ask to speak with the Health Legislative Assistant. You will be transfered to a voicemail where the scripts below can be used.
To Request Cosponsorship:
Hello, this is [Your Name]. I live in [City, Zip]. I’m calling today to talk about H.R. 460, the Patients’ Access to Treatments Act. I would like to see the Representative cosponsor this legislation and want to know what I can do to help make that happen. Please call me at your convenience at [phone number] or via email at [email]. Thank you!
To Thank For Cosponsoring:
Hello, my name is [Your Name] from [City, Zip]. I’m calling to thank the Representative for cosponsoring H.R. 460, the Patients’ Access to Treatments Act. I was wondering if he would reach out to Committee Chairman Upton and Chariman Waxman to ask them to bring the bill for a hearing. Thanks for your help, I look forward to hearing from you. I can be reached via phone at [phone] or email at [email].
Current Legislative Cosponsors:
Rep Amodei, Mark E. [NV-2]
Rep Bachus, Spencer [AL-6]
Rep Bishop, Sanford D., Jr. [GA-2]
Rep Bishop, Timothy H. [NY-1]
Rep Bonamici, Suzanne [OR-1]
Rep Braley, Bruce L. [IA-1]
Rep Brownley, Julia [CA-26]
Rep Capito, Shelley Moore [WV-2]
Rep Capps, Lois [CA-24]
Rep Castor, Kathy [FL-14]
Rep Cicilline, David N. [RI-1]
Rep Clay, Wm. Lacy [MO-1]
Rep Coffman, Mike [CO-6]
Rep Cohen, Steve [TN-9]
Rep Connolly, Gerald E. [VA-11]
Rep Conyers, John, Jr. [MI-13]
Rep Crenshaw, Ander [FL-4]
Rep Cummings, Elijah E. [MD-7]
Rep Davis, Susan A. [CA-53]
Rep DeFazio, Peter A. [OR-4]
Rep Deutch, Theodore E. [FL-21]
Rep Ellison, Keith [MN-5]
Rep Enyart, William L. [IL-12]
Rep Eshoo, Anna G. [CA-18]
Rep Farr, Sam [CA-20]
Rep Frankel, Lois [FL-22]
Rep Frelinghuysen, Rodney P. [NJ-11]
Rep Garamendi, John [CA-3]
Rep Gerlach, Jim [PA-6]
Rep Gibson, Christopher P. [NY-19]
Rep Harper, Gregg [MS-3]
Rep Holt, Rush [NJ-12]
Rep Huffman, Jared [CA-2]
Rep Israel, Steve [NY-3]
Rep Johnson, Eddie Bernice [TX-30]
Rep Johnson, Henry C. "Hank," Jr. [GA-4]
Rep Keating, William R. [MA-9]
Rep Kennedy, Joseph P. III [MA-4]
Rep Kildee, Daniel T [MI-5]
Rep King, Peter T. [NY-2]
Rep Langevin, James R. [RI-2]
Rep Latham, Tom [IA-3]
Rep Lee, Barbara [CA-13]
Rep Lewis, John [GA-5]
Rep Loebsack, David [IA-2]
Rep Lofgren, Zoe [CA-19]
Rep Lujan Grisham, Michelle [NM-1]
Rep Lujan, Ben Ray [NM-3]
Rep Lynch, Stephen F. [MA-8]
Rep Markey, Edward J. [MA-5]
Rep McCarthy, Carolyn [NY-4]
Rep McCollum, Betty [MN-4]
Rep McGovern, James P. [MA-2]
Rep Michaud, Michael H. [ME-2]
Rep Moore, Gwen [WI-4]
Rep Moran, James P. [VA-8]
Rep Norton, Eleanor Holmes [DC]
Rep Payne, Donald M., Jr. [NJ-10]
Rep Perlmutter, Ed [CO-7]
Rep Pingree, Chellie [ME-1]
Rep Pocan, Mark [WI-2]
Rep Poe, Ted [TX-2]
Rep Price, David E. [NC-4]
Rep Rangel, Charles B. [NY-13]
Rep Rooney, Thomas J. [FL-17]
Rep Ros-Lehtinen, Ileana [FL-27]
Rep Roybal-Allard, Lucille [CA-40]
Rep Runyan, Jon [NJ-3]
Rep Ryan, Tim [OH-13]
Rep Schiff, Adam B. [CA-28]
Rep Schwartz, Allyson Y. [PA-13]
Rep Scott, David [GA-13]
Rep Scott, Robert C. "Bobby" [VA-3]
Rep Shea-Porter, Carol [NH-1]
Rep Slaughter, Louise McIntosh [NY-25]
Rep Speier, Jackie [CA-14]
Rep Takano, Mark [CA-41]
Rep Thompson, Bennie G. [MS-2]
Rep Tierney, John F. [MA-6]
Rep Titus, Dina [NV-1]
Rep Tonko, Paul [NY-20]
Rep Tsongas, Niki [MA-3]
Rep Welch, Peter [VT]
Rep Wittman, Robert J. [VA-1]
Rep Wolf, Frank R. [VA-10]
Rep Young, C. W. Bill [FL-13]
Rep Young, Don [AK]