A Michigan lawmaker is targeting an insurance loophole that can drive up prescription drug costs - often without patients even realizing it.
State Sen. Stephanie Chang, D-Detroit, has introduced legislation to change what are known as co-pay accumulator programs, which critics say are costing Michiganders lots of out-of-pocket costs.
With nearly 69,000 people in the state expected to be diagnosed with cancer this year, according to the American Cancer Society, supporters say the policy could impact many patients who rely on costly medications. Chang explained how accumulators work.
"You can use a coupon for the copay, but it doesn't actually reduce your deductible in any real sense," said Chang. "And so people end up still having to pay the same amount that they would have had to."
She warned that this kind of challenge can force patients to choose between paying their bills and staying on treatment. Her legislation was introduced last week and has been referred to a Senate committee, where it will need a hearing before moving forward.
Chang said she's confident it will receive bipartisan support. Insurance groups counter the programs help control rising drug costs and keep premiums from increasing for everyone.
For patients, the loophole can come as a surprise. Stacey Goins of Greenville is an ovarian cancer survivor who experienced financial hardships due to high costs for her treatment and the insurance accumulator adjustment programs.
"On top of fighting cancer, you're trying to figure out how to financially," said Goins, "and I'm, I'm a single woman trying to keep a house over my head and pay for bills, plus being between work and having to be off for my chemo treatments."
Goins said when she added everything up, she would have saved about $5,000 out of pocket - and she said she’s grateful to see the issue getting attention.
"I am so thankful for, uh, Senator Chang for her putting herself out," said Goins. "Like we think this is just a little issue, but this is a big dragon to go up against."
