In September, the Coalition for Accessible Treatments (CAT, of which NHF is a member) hosted two briefings to discuss the release of a new study on specialty tiers and why this insurance practice impedes patient access to treatments. CAT comprises 20 patient and provider groups advocating for the passage of H.R. 460, the Patients’ Access to Treatments Act. The bill prohibits private insurers from charging patients more in cost-sharing for drugs on the 4th, or specialty tier, than they do for drugs on the 3rd tier.
The briefings focused on the release of a new study by Avalere, a healthcare consulting firm in Washington, DC, on the potential impact the bill would have on premiums and cost-sharing in private health insurance plans. Avalere’s study, estimates that H.R. 460 will increase premiums on average $3 per year for plans with specialty tiers, absent any other changes to the benefit design.
The briefings also featured consumers, including bleeding disorders advocate Nathan Wilkes, who shared personal stories on why specialty tiers are so challenging for individuals with high-cost, chronic conditions. Following the briefings, NHF joined other CAT members in meeting with Congressional staff to increase the number of co-sponsors on H.R. 460 and to identify Senate champions to introduce companion legislation. NHF and the Hemophilia Federation of America (HFA) sent a joint letter to Congressional leaders asking them to schedule a hearing on H.R. 460, so that it can begin to move through the legislative process.
NHF will continue to advocate for passage of H.R. 460. We will update the community as the bill progresses.