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Thursday, May 15, 2014

SCREWED! New Report Shows Out-Of-Pocket For Medicine Doubles Under Obamacare


A new study commissioned by the Pharmaceutical Researchers and Manufacturers of America (PhRMA) finds that many consumers in ObamaCare’s insurance exchanges will end up paying more than twice as much in out-of-pocket drug costs.

The report  was conducted by actuarial firm Milliman,  found that people on the Silver Plan, which is the most popular ObamaCare plan, would likely pay 130%  more for out-of-pocket prescription drugs compared to people on similar employer-sponsored plans.

Recently S&P Capital IQ predicted up to144 Million Americans will lose their employer plans once the employer mandate kicks in next year and forced onto the Obamacare exchange.
Further, the report concludes that Silver plans with combined deductibles impose 130 percent higher cost sharing for prescription medicine than typical employer-sponsored plans, compared to about a 20 percent increase for other health care services for members without subsidies that previously had typical employer coverage.
Studies have found that higher out-of-pocket costs reduce patients’ likelihood of taking prescription medicines to manage chronic conditions. The result is an increase in hospitalizations and higher health care costs overall. Conversely, programs that encourage better adherence have the potential to reduce emergency department visits, hospitalizations, and other preventable, costly care. In fact, according to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.
“Medicines are one of the most significant contributors to improved quality and length of life for people with serious diseases, such as chronic illnesses, cancer, and HIV/AIDS,” said Castellani. “To improve health and, in turn, control health care costs, we must continue to work toward a health care system that improves access and adherence to medicines.”
- See more at: http://www.phrma.org/media-releases/hix-out-of-pocket-for-prescriptions-compared-to-employer-plans#sthash.cauHg1b0.dpuf
Americans participating in the Exchanges were promised coverage comparable to employer plans and yet the reality is that many new plans are failing to provide an appropriate level of access to quality, affordable health care,” said John Castellani, President and CEO of PhRMA. “Patients face hurdles in accessing the medicines they need to manage their conditions, which is particularly problematic for Americans trying to control their chronic diseases.”
The Milliman report also noted that Silver plans are nearly four times more likely to have a single combined deductible for medical and pharmacy benefits (46 percent of the time) compared to typical employer-sponsored plans (12 percent of the time). This is an important distinction, particularly for patients with chronic illnesses, as it means prescription medicines are not covered until patients meet the deductible. According to Milliman’s analysis, the typical deductible for Silver plans is $2,000. Previous research from Avalere Health found that in the lower-cost Bronze plans, deductibles are even higher, averaging more than $4,000.
- See more at: http://www.phrma.org/media-releases/hix-out-of-pocket-for-prescriptions-compared-to-employer-plans#sthash.cauHg1b0.dpuf
Americans participating in the Exchanges were promised coverage comparable to employer plans and yet the reality is that many new plans are failing to provide an appropriate level of access to quality, affordable health care,” said John Castellani, President and CEO of PhRMA. “Patients face hurdles in accessing the medicines they need to manage their conditions, which is particularly problematic for Americans trying to control their chronic diseases.”

The Milliman report also noted that Silver plans are nearly four times more likely to have a single combined deductible for medical and pharmacy benefits (46 percent of the time) compared to typical employer-sponsored plans (12 percent of the time). This is an important distinction, particularly for patients with chronic illnesses, as it means prescription medicines are not covered until patients meet the deductible. According to Milliman’s analysis, the typical deductible for Silver plans is $2,000. Previous research from Avalere Health found that in the lower-cost Bronze plans, deductibles are even higher, averaging more than $4,000.
The full report can be read here.

Further, the report concludes that Silver plans with combined deductibles impose 130 percent higher cost sharing for prescription medicine than typical employer-sponsored plans, compared to about a 20 percent increase for other health care services for members without subsidies that previously had typical employer coverage.
Studies have found that higher out-of-pocket costs reduce patients’ likelihood of taking prescription medicines to manage chronic conditions. The result is an increase in hospitalizations and higher health care costs overall. Conversely, programs that encourage better adherence have the potential to reduce emergency department visits, hospitalizations, and other preventable, costly care. In fact, according to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.
“Medicines are one of the most significant contributors to improved quality and length of life for people with serious diseases, such as chronic illnesses, cancer, and HIV/AIDS,” said Castellani. “To improve health and, in turn, control health care costs, we must continue to work toward a health care system that improves access and adherence to medicines.”
- See more at: http://www.phrma.org/media-releases/hix-out-of-pocket-for-prescriptions-compared-to-employer-plans#sthash.cauHg1b0.dpuf
Further, the report concludes that Silver plans with combined deductibles impose 130 percent higher cost sharing for prescription medicine than typical employer-sponsored plans, compared to about a 20 percent increase for other health care services for members without subsidies that previously had typical employer coverage.
Studies have found that higher out-of-pocket costs reduce patients’ likelihood of taking prescription medicines to manage chronic conditions. The result is an increase in hospitalizations and higher health care costs overall. Conversely, programs that encourage better adherence have the potential to reduce emergency department visits, hospitalizations, and other preventable, costly care. In fact, according to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.
“Medicines are one of the most significant contributors to improved quality and length of life for people with serious diseases, such as chronic illnesses, cancer, and HIV/AIDS,” said Castellani. “To improve health and, in turn, control health care costs, we must continue to work toward a health care system that improves access and adherence to medicines.”
- See more at: http://www.phrma.org/media-releases/hix-out-of-pocket-for-prescriptions-compared-to-employer-plans#sthash.cauHg1b0.dpuf
Further, the report concludes that Silver plans with combined deductibles impose 130 percent higher cost sharing for prescription medicine than typical employer-sponsored plans, compared to about a 20 percent increase for other health care services for members without subsidies that previously had typical employer coverage.
Studies have found that higher out-of-pocket costs reduce patients’ likelihood of taking prescription medicines to manage chronic conditions. The result is an increase in hospitalizations and higher health care costs overall. Conversely, programs that encourage better adherence have the potential to reduce emergency department visits, hospitalizations, and other preventable, costly care. In fact, according to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.
“Medicines are one of the most significant contributors to improved quality and length of life for people with serious diseases, such as chronic illnesses, cancer, and HIV/AIDS,” said Castellani. “To improve health and, in turn, control health care costs, we must continue to work toward a health care system that improves access and adherence to medicines.”
- See more at: http://www.phrma.org/media-releases/hix-out-of-pocket-for-prescriptions-compared-to-employer-plans#sthash.cauHg1b0.dpuf

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