Coalition Endorses Additional Patient Protections and Urges Further Action against Discrimination
Washington, DC (December 19, 2014) – Today, the “I Am (Still) Essential” coalition of patient groups sent a letter signed by 279 organizations to Health and Human Services (HHS) Secretary Sylvia Mathews Burwell applauding the recently released Notice of Benefit and Payment Parameters for 2016 which, once finalized, define Essential Health Benefits (EHB) for Qualified Health Plans (QHPs) in the future under the Affordable Care Act (ACA). The letter detailed how the many positive changes in the proposed rule will improve the plans available to patients. The letter also suggests additional changes that will increase positive patient outcomes and urges the rule to be finalized without diminishing any of the proposed improvements.
“Despite its short tenure, the ACA has already increased patient access to care,” said Andrew Sperling, Director of Federal Legislative Advocacy at National Alliance on Mental Illness. “While it is not perfect, based on the proposed changes contained in the rule, we are optimistic the program will continue to evolve to serve patients better.”
The coalition, which is comprised of groups representing millions of patients throughout the country, has been working to shed light on discrimination and barriers-to-care that patients, specifically those with chronic conditions, have encountered under the plans offered within the Health Insurance Marketplace.
The latest notice from HHS directly addresses several access-to-care issues the coalition raised in a July letter to the department. The patient groups applaud HHS for proposing new procedures that should result in plans covering more prescription medications to meet patient needs and avenues to access medications not covered by a plan through exceptions processes. The proposed rule also increases transparency so that enrollees have access to more information regarding providers and prescription formularies. The patient groups also support the HHS proposal that prohibits plans from delivering medications only through the mail.
“We are pleased that many of the concerns highlighted by the patient community are being recognized and addressed by Secretary Burwell,” said Angela Ostrom, Chief Operating Officer and Vice President of Public Policy at the Epilepsy Foundation. “We urge HHS to ensure all of these positive changes are incorporated into the final rule and to implement them in 2016 and not wait until 2017. Patients should not wait another year for these modifications to occur; they need the ACA to work for them now.”
Despite ongoing improvements that are applauded by the group, the coalition urged further action from HHS on the matter of discrimination and high patient cost-sharing for medications. While the notice from HHS declares that placement of most or all drugs for a specific condition on the highest cost tier constitutes discrimination, the coalition urges HHS to begin to enforce this and address other discriminatory barriers to care such as high co-insurance. The letter from the coalition also requests further regulatory guidance on what constitutes discrimination in the marketplace.
“The changes proposed by HHS contained in the proposed rule should have an immense and positive impact on patients’ access to appropriate care,” said Carl Schmid, Deputy Executive Director of the AIDS Institute. “We encourage Secretary Burwell to implement these positive proposals in a final rule immediately and enforce the law to end discriminatory practices.”
Groups signing onto the letter include: The AIDS Institute, American Autoimmune Related Diseases Association, Colon Cancer Alliance, Easter Seals, Epilepsy Foundation, Lupus Foundation of America, National Alliance on Mental Illness, National Kidney Foundation, National Multiple Sclerosis Society, and Parkinson’s Action Network.