PARSIPPANY — A second Assembly panel advanced legislation by Assemblywoman BettyLou DeCroce that caps out-of-pocket expenses for prescription drugs. The Appropriations Committee approved the bill by a 9-0 vote. The bill (A2431) caps a patient’s share to $150 or $250 a month depending on the health benefit plan level.
“Many people with high cost-sharing plans don’t take vital medications prescribed by their doctors because they can’t afford their co-pays,” said DeCroce (R-Morris). “The result is poor health outcomes and increased long term costs for chronically ill patients. Capping out-of-pocket payments will reduce health care costs in the long run.”
According to a study commissioned by the Leukemia and Lymphoma Society, high-cost sharing plans have been shown to lower medication utilization and adherence, leading to poor health outcomes and an increase in longer-term costs.
Delaware, Maryland, Louisiana, California and the District of Columbia have passed similar legislation. Maine and Vermont have limits on the annual out-of-pocket costs to consumers, and Virginia and five other states require insurance companies to provide notice to consumers of cost-sharing tiers and all changes to the plans.
The provisions of the measure apply to the state’s individual and small employer plans, the state health benefits program and the school employees’ health benefits program.