Tackling Rising Prescription Drug Prices
Prescription drug costs have skyrocketed and are now the fastest growing contributor to premiums. These costs continue to be one of the leading factors driving up health care costs for Californians. Health plans are actively advocating for policies and programs to rein in prescription drug costs.
- Ending Pay-to-Delay Schemes: We advocated for AB 824 (Wood) which was signed into law by Governor Newsom. It will give the Attorney General greater tools to crack down on pay-for-delay schemes — bringing more generic drugs into the marketplace to improve Californians’ access to affordable health care. Pay-for-delay agreements, also known as reverse payment settlements, occur when major brand-name pharmaceutical companies pay off generic manufacturers to delay entering their lower-priced generic versions of the drug into the market for a set period of time. Pay-for-delay agreements take money from patient pockets to unfairly increase drug company profits. AB 824 is a step in the right direction to lower prescription drug prices and health care costs for all.
- Advocating for Transparency in Drug Pricing: Health plans championed the nation’s first comprehensive legislation aimed at reducing prescription drug prices by advocating for transparency requirements into Pharma’s pricing tactics that, until this year, have stayed hidden. This legislation, which was passed in 2017, and the data released under the law in the summer of 2019, helps address the growing affordability crisis by requiring drug companies to give health plans, policymakers, and the public notice of major price increases for the most expensive drugs.
Advocating to Stop Third-Party Health Providers from Gaming the Health Care System and Driving Up Costs for All
Unnecessary inflated medical claims drive up the cost of health insurance premiums for everyone. Californians should not have to pay the price for dishonest third parties in the dialysis and drug rehabilitation industries seeking to financially benefit from unnecessary and inflated medical claims.
That’s why we worked to advocate for the passage of AB 290 (Wood). The bill, signed into law by Governor Newsom, will increase consumer protection and provide transparency about where payments on behalf of patients to dialysis companies and loosely regulated drug rehabilitation centers are coming from, and remove the financial incentive for unscrupulous third-party payers to bill health plans for inflated and unnecessary medical claims.
Advocating to Protect Gains Made Under the Affordable Care Act
Health plans supported the passage of a state-based Individual Shared Responsibility Requirement to have health coverage. This new law will help to stabilize the market and generate hundreds of millions in new state funding annually that can be used to help make health coverage more affordable for low-income and working families and individuals in California.
The requirement to buy coverage is the best method to stabilize California’s health care marketplace and is a crucial step that will allow us to move toward finding real solutions to achieve universal coverage by closing the remaining 6.8% gap of uninsured Californians.
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