S5, Ep 6- Copay Accumulators Explained: Why Advocacy Matters

10/27/22 • 17 min

1 Listener

The impact of copay accumulator policies can create additional financial difficulties for patients by limiting payments that count toward their annual deductibles and out-of-pocket maximums. As a result, millions of patients who are already struggling with the financial and physical toll of their condition may delay care or stop taking their medication altogether leading to worsening health.

“Copay accumulator adjusters are a program used by insurance companies to force patients to take medications that they determine are cheaper for them. And, in reality, it's actually just cheaper for the insurance company,” says Corey Greenblatt, Senior Manager of Policy and Advocacy at GHLF.

Our guests, JP Summers, Patient Advocate and Community Outreach Manager at GHLF, and Corey, tell us more about their advocacy efforts and about their support for the bipartisan bill called the HELP Copays Act.

Among the highlights in this episode:

1:24: Listener comment

1:56: H.4929, a step therapy protection law, was passed by both the Massachusetts House and Senate in October after being introduced for the first time over five years ago

2:37: “Governor Baker has 10 days to sign this bill; otherwise, it will die and it would need to be repassed next year,” says Zoe Rothblatt, Associate Director of Community Outreach at GHLF

2:50: Results from a recent GHLF COVID-19 Patient Support Program quick poll shows that most respondents will be celebrating the holidays in person with only 5 percent canceling plans or celebrating virtually

3:30: Steven Newmark, Director of Policy at GHLF, gives some tips to stay safe this holiday season

5:42: JP Summers describes her – and Corey Greenblatt’s – participation to the virtual advocacy event: All Copays Count Coalition Hill Day

6:54: What are copay accumulators?

8:47: The HELP Copays Act explained

9:27: A look back at JP Summers’ chronic illness journey and how the HELP Copays Act could impact her and other patients if passed

11:35: Are there bills similar to the HELP Copays Act at the state level?

12:18: How patients can get involved and advocate for themselves

12:59: What goes through an advocate’s mind when meeting with elected officials?

15:38: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Director of Policy at GHLF: [email protected]

Zoe Rothblatt, Associate Director, Community Outreach at GHLF: [email protected]

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to [email protected]

Catch up on all our episodes on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Among the highlights in this episode:

1:24: Listener comment

1:56: H.4929, a step therapy protection law, was passed by both the Massachusetts House and Senate in October after being introduced for the first time over five years ago

2:37: “Governor Baker has 10 days to sign this bill; otherwise, it will die and it would need to be repassed next year,” says Zoe Rothblatt, Associate Director of Community Outreach at GHLF

3:30: Steven Newmark, Director of Policy at GHLF, gives some tips to stay safe this holiday season

5:42: JP Summers describes her – and Corey Greenblatt’s – participation to the virtual advocacy event: All Copays Count Coalition Hill Day

6:54: What are copay accumulators?

8:47: The HELP Copays Act explained

9:27: A look back at JP Summers’ chronic illness journey and how the HELP Copays Act could impact her and other patients if passed

11:35: Are there bills similar to the HELP Copays Act at the state level?

12:18: How patients can get involved and advocate for themselves

12:59: What goes through an advocate’s mind when meeting with elected officials?

15:38: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Director of Policy at GHLF: [email protected]

Zoe Rothblatt, Associate Director, Community Outreach at GHLF: [email protected]

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to [email protected]

Catch up on all our episodes on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Previous Episode

S5, Ep 5- Vaccine Skepticism: A Worrisome Trend Beyond COVID-19

COVID-19 vaccines have been effective in saving lives but as winter approaches and yet another coronavirus surge is expected, public health leaders face growing skepticism and apathy toward the vaccines. Worse yet, it seems that the politicized backlash against COVID-19 vaccinations is fostering skepticism about routine vaccinations -- in general -- from childhood immunizations to flu shots.

More than 80 anti-vaccine bills have been introduced in state legislatures. While vaccine skepticism remains a minority position in the U.S., the general consensus on vaccine importance and value is not quite as strong as it once was.

Among the highlights in this episode:

0:57: Listener comment

1:33: While flu activity remains low overall, there are increases in certain parts of the country, specifically the Southeast and South-central regions according to the CDC’s first FluView report of the season

2:39: The FDA announced on October 12 that children as young as five are now eligible to receive the bivalent booster

2:59: October 20 marks World Osteoporosis Day, a reminder it's a good time to advocate for yourself and to be proactive about your health and your family's health, so bring up bone health with your doctor

3:18: Zoe Rothblatt, Associate Director of Community Outreach at GHLF, lists fast facts about osteoporosis

4:22: “Anti-vaccine sentiment is higher now than it was even before the pandemic began. There's some irony in that. We dealt with a global pandemic, and it was vaccines and scientific development generally that are helping get us out of this pandemic and moving into a safer phase. And yet vaccine skepticism is higher than it's ever been,” says Steven Newmark, Director of Policy at GHLF

4:45: Why did vaccine skepticism increase and how can we counter this trend?

6:06: 80 anti-vaccine bills have been introduced in state legislatures around the country

7:01: Childhood vaccination rates fell during the 2020-2021 school year, equating to 35,000 kids not being up to date on their shots

7:37: “Fewer Americans said this year... that they'll get their flu shot, compared to the few years before,” says Zoe Rothblatt

9:42: A culture of distrust in government has developed over the last three decades and some social media platforms and media outlets thrive on constantly criticizing information coming from government sources, including from neutral sources like the CDC

10:55: “I saw some data that showed if 80 percent of eligible Americans got [the] latest COVID boosters, as many as 90,000 lives could be saved,” says Zoe Rothblatt

12:30: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Director of Policy at GHLF: [email protected]

Zoe Rothblatt, Associate Director, Community Outreach at GHLF: [email protected]

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to [email protected]

Catch up on all our episodes on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Next Episode

S5, Ep 7- Cancer Fashionista: Advocating in Style

In this episode, Melissa Berry, founder of Cancer Fashionista and a fashion and beauty publicist, shares how her breast cancer diagnosis sparked her to become an advocate. Through her blog, she now provides fashion, beauty, and wellness advice to help patients feel good about themselves and feel better prepared to manage their care.

“Your doctor is your consultant. Doctors are not gods; they're human beings. So go to them with information and questions, and come up with a health plan for you. I think that's just the golden key right there,” says Melissa.

Among the highlights in this episode:

1:27: Listener comment

2:05: Anxiety and depression are on the rise, having been intensified by the pandemic. Plus, we’re experiencing a therapist shortage.

2:59: “Such an important part of self-advocacy is making sure you're emotionally and mentally well,” says Zoe Rothblatt, Associate Director of Community Outreach at GHLF

3:21: Open enrollment for marketplace health insurance has begun, and you can enroll online at healthcare.gov until mid-January 2023

3:38: Premiums are increasing this year, but impact on costs should be limited as Congress passed a 3-year extension of enhanced subsidies as part of the Inflation Reduction Act

4:45: GHLF will be presenting some of its research findings, including patient perspectives, at the upcoming American College of Rheumatology (ACR)

6:48: Melissa Berry aka Cancer Fashionista shares her family history of breast cancer and her journey in getting diagnosed

9:12: Melissa walks us through her thoughts at the time of her diagnosis as well as the support system and resources that helped her in her cancer journey

10:43: From patient to advocate: Melissa reflects on the things she couldn’t find as a patient and how that pushed her toward advocacy and developing resources to help others

12:55: Cancer Fashionista, more than an online resource: a sisterhood

13:49: “If you know that you have a genetic predisposition to something like breast cancer, there's so many things you can do to prevent it. So why not jump ahead of the curve... And that goes for anything: MS [Multiple Sclerosis], diabetes, cancer. It's incredible what they can do with genetic testing these days... It cannot hurt to ask your primary care physician: Can I get a panel done?” says Melissa

15:37: Check out Melissa’s podcast ‘Dear Cancer, I'm Beautiful’

17:10: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Director of Policy at GHLF: [email protected]

Zoe Rothblatt, Associate Director, Community Outreach at GHLF: [email protected]

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to [email protected]

Catch up on all our episodes on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.