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AIDS Group Says ACA Plan Copay Accumulators are More Common Than Not
Copay accumulators are a common feature in health insurance plans sold on the ACA exchanges, according to a recent report from an AIDS advocacy group that wants the Biden administration to reverse a decision made by the Trump administration that allowed continued use of accumulators.
Copay accumulators are a common feature in health insurance plans sold on the ACA exchanges, according to a recent report from an AIDS advocacy group that wants the Biden administration to reverse a decision made by the Trump administration that allowed continued use of accumulators.
The AIDS Institute issued a report in March that says that at least two-thirds of the ACA health plans in 35 states include a copay accumulator and that in 14 states, every plan does.
Copay accumulators remove any copay assistance that members receive from spending that would count toward a health plan’s deductible. Patient advocacy groups say accumulators undermine copay assistance and protection against the high cost of drugs. And the AIDS Institute says in its report that they doubly benefit insurers and PBMs because they receive the copay assistance funds and then the amount the member spends until the plan’s out-of-pocket maximum is reached. The counterargument from insurers and PBMs is that accumulators sabotage formularies and wind up making healthcare and premiums more expensive.
Last year, the Trump administration moved to limit accumulators and then reversed course. The AIDS Institute wants the Biden administration to change the Trump administration’s policy and rein in the use of accumulators.
Illuminating the Dark Corners of HIV-1 Persistence: Insights from Nonsuppressible Viremia
December 4th 2023Some people still have low levels of HIV despite taking antiretroviral therapy as prescribed and lacking any indications of drug resistance. Understanding why could yield new strategies for dealing with HIV.
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35th World AIDS Day Marks 20 Years of PEPFAR: Challenges and Strategies to Combat HIV/AIDS
November 29th 2023PEPFAR, having invested $100 billion and saved 25 million lives in the global fight against HIV/AIDS, faces Congressional hurdles in its reauthorization due to abortion debates. Despite widespread support and no evidence of abortion-related activities, the legislative process is at a standstill. Members of PEPFAR and authors of a recent editorial stress the significance of PEPFAR and advocate for integrating behavioral and social science into healthcare programs to achieve UNAIDS targets and address barriers in HIV/AIDS testing and treatment.
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Study Raises Concerns Over Insurance Barriers to HIV Prevention Medications
November 29th 2023Despite its efficacy, PrEP remains underutilized compared to the need for it. High costs are among the barriers to PrEP use, along with limited knowledge among clinicians, lack of health insurance, stigma, and underestimation of personal HIV risk.
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