Sunday, March 23, 2014

Sunday Globe Special: Obummercare's Pre$cription Drug Problem

Don't forget, it was the in$urers and pre$cription pharmaceutical companies that wrote the bill that became law:

"Cost of drugs rises for chronically ill; US health law can mean hefty charges up front" by Kelli Kennedy | Associated Press   March 23, 2014

MIAMI — Breast cancer survivor Ginny Mason was thrilled to get health coverage under the federal Affordable Care Act despite her preexisting condition.

No waiver but they charge you more!

But when she realized her arthritis medication fell under a particularly costly tier of her plan, she was forced to switch to another brand....

Mason is one of the many Americans with serious illnesses — including cancer, multiple sclerosis, and rheumatoid arthritis — who are indeed finding relatively low monthly premiums under President Obama’s law.

But some have been shocked at how much their prescriptions are costing....

‘‘I was grateful for the Affordable Care Act because it didn’t turn me down but . . . it’s like where’s the affordable on this one,’’ said Mason, 61, of West Lafayette, Ind., who pays an $800 monthly premium.

It's his way of $aying he loves you.

Before the federal health law took effect, Mason paid slightly more for her monthly premium on a plan that didn’t cover her arthritis or pain medications and some routine doctor’s visits.

Avalere Health, a market research and consulting firm, estimates that some consumers will pay half the cost of their specialty drugs under health overhaul-related plans, while customers in the private market typically pay no more than a third. Patient advocates worry that insurers may be trying to discourage chronically ill patients from enrolling by putting high-cost drugs onto specialty tiers....

No!

Patients advocates warn that those with serious illnesses could pay their entire out-of-pocket cap before their insurance kicks in any money....

Insurers can generally choose to put whichever drugs they want into the specialty tier of a plan. Generic drugs for blood pressure or cholesterol typically fall into categories that require patients to pay less than $20 out of pocket.

But patients can end up spending significantly more when they pay for a percentage of a specialty drug’s cost....

Even before the Affordable Care Act took effect, insurers had increasingly begun requiring patients to pay a percentage of the drug costs instead of a flat copay, but analysts say patients often spend more for their prescriptions in plans offered under the health law because of the co-insurance.

‘‘There’s a significant percentage of plans who are using co-insurance of 50 percent or higher,’’ said Caroline Pearson, who tracks the health care overhaul for Avalere Health, which studied plans in 19 states. ‘‘It is generally a lot higher than what we see in private insurance.’’

Once they pay a few hundred dollars, Pearson says, patients start to abandon their medications.

Because they can no longer afford them?

--more--"

Time for me to move on.