Liston Introduces Legislation to Lower Drug Costs and Protect Ohioans from Harmful Insurance Practices

COLUMBUS – Today, state Senators Beth Liston (D-Dublin) and Susan Manchester (R-Waynesfield) introduced a bipartisan bill that would stop health insurers from using copay accumulator programs. The bill ensures that all payments, whether made by a patient or on their behalf, count toward the patient’s out-of-pocket costs for prescription drugs.

“Money is money, no matter who’s paying,” said Senator Liston. “If someone gets help paying for their medication, that help should count toward what they owe, not disappear into the insurance company’s pocket.” 

Sometimes patients, especially those with chronic or rare diseases, rely on coupons or copay assistance from drug manufacturers or nonprofits to afford their medications. However, some insurance companies use copay accumulator programs to ignore that help, refusing to count it toward a patient’s deductible or out-of-pocket maximum. As a result, patients are left with unexpectedly high bills when the assistance runs out.

This bill bans that practice. It applies to all health insurers in Ohio and:

• Stops insurers from designing drug benefits based on whether a patient is receiving financial assistance.
• Requires insurers to count all payments toward out-of-pocket costs like deductibles and copays, whether they are from the patient or someone helping them.
• Protects patients from excessive charges by capping out-of-pocket costs at federal limits.

This legislation is about fairness and making sure patients get the full benefit of any help they receive to afford life-saving medications.