REP. ANDRADE SPONSORS BILL TO PROTECT PATIENTS; MAKE MEDICINE AFFORDABLE
House Bill 3605 aims to cap copayments, critical help for those with chronic diseases
House Bill 3605 is a lifeline to patients like James, a 22-year-old hemophiliac living in Palatine, IL, whose medicine can cost $5,000 per dose and up to $40,000 per month. Until his family meets their annual $3,000 deductible through other medical costs, insurance currently will not cover James' costs.
"This bill will allow my family to order James' medicine even before we meet our $3,000 deductible, which can take months," says Theresa, James' mother. "If this legislation passes, my son will no longer wait for his medication as we work to meet our deductible."
House Bill 3605 would cap out-of-pocket costs per prescription, per 30-day supply on a bifurcated approach: medications on silver, gold and platinum plans would be capped at $100 per month and those on bronze plans at $200. These caps would be applied pre-deductible and be inclusive of a patient's annual deductible and out-of-pocket spending limits. All state regulated, fully insured plans and those on the marketplace exchange would be included.
"People living with chronic conditions such as arthritis, epilepsy, HIV and leukemia face lengthy, costly treatments and are often paying 25-50 percent of their medications' costs each month, on top of regular monthly insurance premiums, even with good insurance," said Rep. Andrade. "Who can afford what amounts to an extra month's rent every month? It is wrong and unfair that fully-insured Illinoisans living with serious conditions can't afford the treatments they need. It is time we addressed this issue in Springfield."
A statewide coalition of health organizations, formed in an effort to "Cap the Copay" (www.capthecopay.org), support this bill and its companion in the Senate-Senate Bill 1359, which is sponsored by State Senator Linda Holmes. Members include the AIDS Foundation of Chicago, Bleeding Disorders Alliance of Illinois, Caring Ambassadors, Depression and Bipolar Support Alliance, Epilepsy Foundation of Greater Chicago, Illinois Arthritis Foundation, Illinois Biotechnology Industry Organization, Illinois Mental Health Summit, Illinois Psychiatric Society, International Myeloma Foundation, Leukemia and Lymphoma Society, Mental Health America of Illinois, MPN Research Foundation, National Patient Advocate Foundation and the National Organization for Rare Disorders.
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