Action Center

Ask Congress to make all copays count!
Support the Help Ensure Lower Patient (HELP) Copays Act (H.R. 830/S. 1375)

Introduced by Representatives Buddy Carter (R-GA) and Nanette Barragán (D-CA) in February 2023, with a companion bill introduced by Senator Rodger Marshall (R-KS) in April, the Help Ensure Lower Patient (HELP) Copays Act would prohibit the use of harmful “copay accumulator adjuster programs” (CAAPs).

CAAPs are used by private insurance plans to prevent co-pay assistance from counting towards a patient’s deductible and out-of-pocket maximum. Many people with serious diseases can't afford their medication without copay assistance. These co-pay accumulator programs prevent patients from getting the care and treatment they need. 

While there was a recent court ruling mandating health plans to count copay assistance towards one's deductible and annual cost-sharing limits, enforcement by the federal government has been minimal. We need your help to ensure that patients receive the relief they deserve.

Contact your lawmakers and urge them to support the HELP Copays Act, a bipartisan bill that provides a two-part solution to combat the continued use of copay accumulator adjustment programs:

  • Updating the Affordable Care Act’s (ACA) definition of cost-sharing to require that all out-of-pocket payments made by or on behalf of a patient count toward the patient’s deductible and out-of-pocket limit. This would end copay accumulator programs in marketplace exchange insurance plans.
  • Stipulating that any item or service covered by an employer health plan is part of the essential health benefits (EHB) package and therefore the plan must count any cost sharing towards a person's annual limit. This would end the ACA’s EHB loophole that allows plans to deem certain categories of drugs as non-essential.

Together, let’s make our voices heard and ensure access to affordable healthcare for all.

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