Patient assistance charities provide an invaluable service to the quarter of a million Americans living with chronic and life-threatening diseases. The Marketplace Access Project (MAP) is a group of patient advocacy organizations dedicated to protecting nonprofit insurance premium and cost-sharing assistance for these patients. Many families affected by hemophilia rely on this type of assistance to get their factor covered. The Coalition for Hemophilia B is a member of MAP.
As of mid-May 2018, MAP has reached 150 bipartisan cosponsors for the Access to Marketplace Insurance Act (H.R. 3976). This commonsense legislation would protect charitable patient assistance by modifying a policy of the U.S. Centers for Medicare and Medicaid Services (CMS).
In 2014, CMS issued guidance on third-party insurance payments for the Affordable Care Act (ACA) Exchange plans—but CMS failed to include nonprofit charities on the list of acceptable premium arrangements for patients covered by qualified health plans. Citing this misguided rule, insurance companies in 42 states are denying coverage to patients with chronic and expensive conditions by rejecting the financial assistance patients were previously receiving from third-party charities—making it impossible for vulnerable patients to access care.
If passed, H.R. 3976 would allow nonprofits to provide premium and cost-sharing assistance under CMS guidance and require health insurance companies to accept this financial assistance.
Congress should pass H.R. 3976 to ensure charitable patient assistance can continue to reach those most in-need.
Art Wood of Patient Services, Inc., the founding member of MAP, said, “Keeping patients safe is a nonpartisan issue.” He added, “If it weren’t for these donation-based charities helping patients living with rare and chronic conditions cover the exorbitant costs, the government would have to pay up, and only those lucky enough to qualify for public health care programs would receive government assistance. Congress should pass H.R. 3976 and let charities be charitable.”