Rep. Johnson offers legislation to cap out-of-pocket drug costs

Bill to save people with serious illnesses thousands in drug costs

WASHINGTON – Tuesday, Rep. Hank Johnson (GA-04) introduced the Affordable Access to Prescription Medications Act of 2009, or H.R. 3799, to cap monthly out-of-pocket costs for specialty drugs, including those covered under Medicare Part D and private insurance plans.

The bill is expected to lower prescription costs for 2.5 percent to 10 percent of Americans who are saddled by the highest drug costs.

“Skyrocketing health care costs are crippling individuals and families,” said Johnson. “Especially hard hit are our most vulnerable citizens – the poor and people with serious illness such as Multiple Sclerosis, arthritis and lupus. Providing these folks with access to affordable treatment is paramount if we are serious about reforming a system that is not working for so many Americans.”

Studies show that 20 percent of Americans who are forced to spend more than $250 of their own money on medications per month often do not fill their prescriptions – making their health worse and increasing overall health care costs.

“Out-of-pocket expenses are only getting worse, especially as prescription drug costs increase,” said Johnson. “Prescriptions are the largest single medical out-of-pocket expense for patients, and this bill would go a long way to help reduce that burden.”

Rep. Johnson’s Affordable Access to Prescription Medications Act will:

• Place a cap on Rx costs. The bill caps the amount a person could be charged for any one prescription at $200, and establishes a $500 cap on how much an individual can be charged for all medications per month. All public and private insurance coverage – including Medicare prescription drug plans – are subject to the cap.
  
• Allow greater access to specialty drugs. Patients who take the most expensive and specialized prescriptions under the Medicare prescription drug program are not currently eligible for exemptions if they cannot afford the medications. For all other Medicare-covered prescription drugs, a beneficiary can request an exemption to allow them access to needed drugs. This bill would establish an exemption process for patients who need the higher-cost, specialized prescriptions.
  
• Establish discrimination and cost-sharing studies. The first study will review Medicare prescription drug polices (under Medicare Parts B, C, and D) to ensure it does not violate non-discrimination laws. The second study will examine the impact of prescription drug cost-sharing on beneficiaries and their health.

“In today’s tough economic times and beyond, my legislation ensures that everyday Americans receive the prescription drugs they need and it ensures that they get them at affordable prices. I am proud to introduce this legislation because it is a sensible approach to America’s prescription drug problems,” declared Rep. Johnson.

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