Barrier Free Care - The "No Copay" Bill

Insulin shot

Increasing co-pays and deductibles have become an obstacle to good health care. Doctors want patients to take their medications, but when co-pays and deductibles add up, too often patients wind up making tough decisions about how often to take their medication. We think high-value preventive medications should be "barrier free."

  • Many medications and services for chronic conditions such as hypertension, high cholesterol, diabetes, asthma, depression, and HIV/AIDS are considered “high value” - meaning they are highly effective and prevent much more costly complications.
  • Yet, high co-pays and deductibles discourage adherence to prescribed treatments. Patients skip taking their pills, leading to complications and expensive emergency services and hospitalizations.
  • In Massachusetts, high deductible (over $1250) plans continue to grow, particularly for individuals and those working for small businesses of under 50 workers. State data show that from 2011 to 2013, the proportion of workers in small firms with high deductibles increased from 30 to 38%. For individuals, 45% of those with coverage were in high deductible plans.

Two identical companion bills, An Act to keep people healthy by removing barriers to cost-effective care (S.606 and H. 984), sponsored Senator Lewis and Representative Farley-Bouvier, would end co-pays for cost effective care for people with chronic conditions. The bill would establish a state panel of experts to recommend high-value and cost-effective services, treatments, and prescription drugs that would not be subject to cost sharing under all fully-insured health plans, including MassHealth and commercial insurance.

Background: See this New York Times article, When a Co-Pay Gets in the Way of Health. Studies on the topic are summarized in this brief.

Lead Sponsors: 

Representative Farley-Bouvier and Senator Lewis

House Bill #: 

H. 984

Senate Bill #: 

S. 606