Underwood to Introduce Legislation Eliminating Out of Pocket Costs for Common Life-Saving Medications and Improve Health Outcomes

WASHINGTON— Today, Congresswoman Lauren Underwood (IL-14) will introduce the Chronic Condition Copay Elimination Act, legislation that would eliminate out of pocket costs for common, life-saving prescription drugs, including insulin, used to manage chronic conditions.

The Chronic Condition Copay Elimination Act would require private health insurance plans, including high deductible health plans, to cover certain preventive care and prescription drugs without charging a copayment, coinsurance, or deductible-related fee.

"Prescription drug costs are so high that many Americans just can't afford them, and as a result, people are skipping their insulin, going without an inhaler for asthma, or splitting their pills for serious conditions. It is making individuals sicker and it's devastating families of all income levels," Congresswoman Underwood said. "I've introduced the Chronic Condition Copay Elimination Act as a commonsense solution to help patients afford the prescriptions they know will help keep them out of the hospital. Costs of these drugs need to come down to help ensure no family struggles because a child has asthma or a mom has high blood pressure, and no patient gets sicker because they can't afford to take their medicine as prescribed."

The Chronic Condition Copay Elimination Act would ensure many common medications, devices, and screenings used to treat chronic conditions like diabetes, asthma, heart disease, and depression are covered without out-of-pocket costs by private insurance plans. For example, the following would be required to be offered to patients with chronic conditions without any fees or cost sharing:

• Diabetes-related medications like insulin, devices like glucometers, and important services like hemoglobin A1c testing.
• Asthma-related medications like inhaled corticosteroids and devices like peak flow meters.
• Heart disease-related medications like Angiotensin Converting Enzyme (ACE) inhibitors, beta blockers and statins.
• Depression-related medications like selective serotonin reuptake inhibitors (SSRIs).

The legislation requires similar offerings for conditions including osteoporosis, hypertension, liver disease, and bleeding disorders.

Private health insurance plans, including employer health plans, qualified health plans (QHPs) purchased directly by individuals, and high deductible health plans would be required to offer these medications, devices, and screenings.

Average annual deductibles for employer-sponsored insurance plans have increased 212 percent since 2008. Most individuals with employer-sponsored insurance report that they or a family member skipped or postponed filling a prescription or seeking care because of the cost. Rep. Underwood's legislation improves on the Affordable Care Act's requirement that insurers provide preventive care without cost sharing like copays or coinsurance.

In Congress, Underwood has worked to improve access to quality, affordable health care for more Americans. In July, Underwood hosted a press conference to discuss the impact of the rising cost of insulin. During the event, Underwood released a report compiled by the Committee on Oversight and Reform on the prices of diabetes drugs for seniors and the uninsured, like insulin, which 1.3 million Illinoisans depend on. In March, Underwood introduced the Health Care Affordability Act to reduce premiums for consumers who purchase plans through the Health Insurance Marketplace. The Health Care Affordability Act (H.R. 1868) would expand tax credits to people who don't currently qualify for them because their income is higher than 400 percent of the federal poverty level, and would increase the size of the tax credit for all income brackets. The legislation will build upon the Protecting preexisting Conditions & Making Health Care More Affordable Act of 2019, legislation introduced that would stabilize the Affordable Care Act.

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