The PAN Foundation today announced its 2022 healthcare policy priorities, laying out seven recommendations to promote healthcare access and affordability for all Medicare beneficiaries and commercially insured patients living with life-threatening and serious illnesses.
As the nation approaches the third year of the COVID-19 pandemic, public health and equitable healthcare access must be prioritized by lawmakers. While PAN was disappointed that key affordability protections for people on Medicare, like a cap on annual out-of-pocket costs, were not enacted in 2021, we remain optimistic for meaningful legislation in the coming year.
For years, millions living in the U.S. have struggled to pay for their out-of-pocket prescription costs. According to a study by the Kaiser Family Foundation, the average annual out-of-pocket cost in 2019 for patients requiring a specialty medication was more than $8,000. But according to polling by Morning Consult conducted on behalf of the PAN Foundation in 2021, 75 percent of seniors reported that they can’t afford to pay more than $200 each month. Common sense measures, including an annual limit on out-of-pocket costs and spreading costs out throughout the benefit year, could offer relief to millions.
It is also well documented that disparities in healthcare and health outcomes persist in the U.S., because of broad structural, socioeconomic, political, and environmental factors that are rooted in years of systemic racism. There must be a coordinated effort across all levels of government and leadership to affect change.
Therefore, the PAN Foundation urges the administration and Congress to:
- Establish a national effort to end longstanding health inequities, making healthcare affordable and accessible for all without discrimination.
- Place a monthly or annual cap on out-of-pocket costs for prescription medications for Medicare Part D beneficiaries.
- Spread out-of-pocket costs for prescription medications more evenly throughout the Medicare Part D benefit year.
- Modernize the Medicare Part D Low-Income Subsidy (also known as Extra Help) program to increase enrollment and provide continuity for individuals from one year to the next.
- Prohibit co-pay accumulators or similar programs that lead to greater out-of-pocket costs for commercially insured individuals.
- Require public and private insurers to adopt policies that address social determinants of health to mitigate barriers that prevent patients from adhering to their medications.
- Ensure continued access to telehealth services, particularly for those in rural and underserved areas.
“Another year has come and gone where Medicare beneficiaries have remained the only insured group with no limit on their annual out-of-pocket costs,” said PAN President and CEO Kevin L. Hagan. “Congress must do more to help the most vulnerable among us, those who are living with serious illnesses, and those who are facing barriers to care. We must collectively do better to safeguard the health of our nation.”
Learn more about our healthcare policy recommendations
To read PAN’s complete list of 2022 policy positions, visit panfoundation.org/positions. To join PAN in advocating for these policies and lower out-of-pocket costs, visit our advocacy action center. In just a few clicks, you can send an email to your elected representatives asking them to make healthcare more affordable and accessible.
About the PAN Foundation
The PAN Foundation is an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic, and rare diseases with the out-of-pocket costs for their prescribed medications.
Since 2004, we have provided more than 1 million underinsured patients with $4 billion in financial assistance. Partnering with generous donors, healthcare providers, and pharmacies, we provide the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life. Learn more at panfoundation.org.
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