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Category: 2022 Key Initiatives

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Supporting Long Overdue Colorado Healthcare Consumer Rights

Supporting Long Overdue Colorado Healthcare Consumer Rights

The year 2022 promises exciting and substantive opportunities to bring better health care to Coloradans.  Maybe the most important of these is the discussion around a Colorado Consumer Health Bill of Rights.  Similar initiatives have sprung up in other states, indicative of the need to put consumers front and center in the health care debate.  It is long past time that consumer needs take precedence over the financial interests of health care corporations.  We expect more to come very soon on this critical effort. 

Kavita V. Nair

Kavita V. Nair

LET PATIENTS BENEFIT FROM PRESCRIPTION DRUG REFORM

“Coloradans continue to struggle to pay for their prescription medications. The largest yearly survey of Colorado households conducted by the Colorado Health Institute found that one in five Coloradans skipped health-care services due to cost concerns in 2021. Of the almost 10% of Coloradans who didn’t fill a prescription due to cost, 40% said their health declined.”

Read the full op-ed at: https://www.coloradopolitics.com/opinion/let-patients-benefit-from-prescription-drug-reform/article_36587002-c1e0-11ec-b2b8-579165e42efe.html

Rep Iman Jodeh

St. Rep. Iman Jodeh (D-Arapahoe)

LOWER OUT OF POCKET COSTS AND FIGHT BACK AGAINST COST SHIFTING

“Our bill is essentially a consumer protection bill, making common-sense reforms that will bring integrity and fairness to our health care system and save Coloradans taking expensive medications up to $1,000 a year. 

First, this bill will immediately reduce out-of-pocket prescription costs for Coloradans and prevent insurance companies from pocketing the billions of dollars in prescription drug rebates meant to help Colorado patients pay for their medicine”

https://sentinelcolorado.com/1gridoped/rep-iman-jodeh-our-plan-to-make-health-care-dependable-and-affordable

EMPOWER CONSUMERS AND LESSEN THE STRANGLEHOLD OF INSTITUTIONAL INTERESTS

Too little is being done in Colorado and across the country to put more power in the hands of consumers. Out of pocket costs and ‘skimpy coverage plans’ rob from consumers and oftentimes fail to deliver on the care people need.

The one positive piece of news from the challenges of the global pandemic is the transformative migration to digital health care. Practically overnight, consumers and providers discovered that many aspects of care can be delivered in totally different ways.

We need to take this disruption and convert it into a complete rethinking of how healthcare is provided that centers on the consumer, not the monied institutions that for too long have controlled healthcare policies.

LOWER OUT OF POCKET COSTS AND FIGHT BACK AGAINST COST SHIFTING

According to a new poll, Americans would like to see Congress focus more on reducing the overall costs of health care coverage such as premiums, deductibles, and copays (71%) over reducing the costs of prescription drugs (29%). This extends across party lines; 73% of Democrats and 64% of Republicans would like to see Congress focus on reducing overall costs of coverage.

And it’s no wonder. According to various sources, total out of pocket costs for families in 2018 exceeded $7,500 per year. We all have to be wondering what the point of insurance is if we have to pay upwards of $8,000 before any coverage kicks in.

There are scores of ideas available for Colorado lawmakers to consider that don’t involve draconian measures like setting prices or capping revenues. CHAIN will continue fighting for ways to directly lower out-of-pocket expenses and clamp down on the kneejerk response of shifting costs to consumers by providers whenever changes in the market occur.

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Ensure Federal Drug Program Serves Patients, Not Profits

ENSURING FEDERAL DRUG PROGRAM SERVES PATIENTS, NOT PROFITS

Sprawling government health care programs can mean billions are wasted or misappopriated.  The 340-B program, a $29b effort to lower the cost of prescription drugs for those most in need, is a classic case.  The program has morphed into a source of profits for hospitals and other providers, taking billions in benefits away from low income and underserved families in need.  CHAIN is working toward restoring integrity to the 340-B program, and calling out similar government initiatives that have gone off course.  

Drugs

Prescription Drugs: Spending, Use, and Prices

In recent years, policymakers have expressed concerns about the high prices of prescription drugs. Those drugs offer wide-ranging benefits, such as reducing the need for services provided by physicians and hospitals, improving the quality of life, and extending life. However, high prices reduce consumers’ access to such medications. They also contribute to higher spending that strains budgets, including the federal budget.

https://www.cbo.gov/publication/57772

 

HOW INTENT MORPHS INTO ABUSE

The 340B program is a classic case of good government intent can morph into abuse, and why we should exercise extreme caution with further government intervention.

According to the Pacific Research Institute:

By attempting to help vulnerable patient populations in such an overly complicated manner, the 340B program creates inefficiencies throughout the broader healthcare system… These include vulnerable patients not receiving any of the price savings, the abuse of the 340B program by covered entities, increased incentives to prescribe more expensive medicines, a shifting of drug costs on to non 340B patients, and an unwarr-anted consolidation of medical practices. Due to these inefficiencies, the 340B program worsens the quality of the overall health care system.

Instead of drug discounts flowing to those families most in need, the PRI report demonstrates how millions of dollars are likely flowing to the coffers of hospitals and other providers.

https://www.pacificresearch.org/comprehensive-regulatory-reform-from-the-bottom-up-the-case-of-340b/

PUSH FOR GOVERNMENT AND INSTITUTIONAL ACCOUNTABILITY

A report by the non-partisan Government Accountability Office (GAO) layout out the path for greater accountability.  The GAO found major gaps in the administration of the program and lax accounting/reporting standards.  They conclude their work with six strong recommendations for reforming how the 340B program operates, including audits that verify the proceeds from discounted drugs are being used to lower the cost to consumers in need.

https://www.gao.gov/products/gao-20-108 

SUPPORT COMMUNITY MEMBERS WHO ARE TAKING ACTION

CHAIN fully supports Coloradans engaged in demanding greater accountability and transparency in the 340B program.  We urge everyone to look at 340B as the cautionary tale for why creating massive government programs to address health care inequities should be among the last strategies used.