A sensible cap on costly prescription drugs


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To help prevent Americans from being bankrupted by medical bills, the 2010 federal healthcare law placed an annual cap on deductibles, co-pays and other out-of-pocket costs imposed by health insurers. That's turned out to be a mixed blessing for Americans who suffer from certain chronic diseases, including multiple sclerosis and HIV/AIDS. The specialty medicines they rely on are so costly that they can run up thousands of dollars in prescription drug bills early in the year, hitting the annual cap in short order. And as a study by the Kaiser Family Foundation showed, the typical household doesn't have nearly enough money on hand to cover a full year's out-of-pocket costs all at once. To help them spread out their bills in a more manageable way, the state's insurance exchange, Covered California, may require insurers to cap the monthly cost of each expensive specialty prescription at $500. That's a step in the right direction, but it doesn't go far enough to make sure those ailing Californians can afford the medicines they need. Lowering the cap to $200 would provide significantly more help, and given the limited number of people who need the help, the cost to other policyholders is expected to be minimal, according to a report by an independent actuary. Read full article.

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