Trump Policy Proposal Would Cost HIV+ Americans At The Pharmacy

A new policy proposal from the Trump administration could affect a lot of LGBTQ Americans in terms of healthcare and their wallets.

The Washington Blade reports the Centers for Medicare and Medicaid Services issued a draft rule last month that would allow insurance companies to ignore ‘co-pay coupons’ for prescription drugs in regard to computing a patient’s out-of-pocket spending.

In the past, insurance companies have allowed copay coupons (which reduce prices at checkout) to count towards a patient’s deductible and out-of-pocket limits.

For instance, if you are a gay man who takes PrEP (pre-exposure prophylaxis) as protection against HIV infection, you may be acquainted with Gilead’s Advancing Access co-pay coupon card which pays up to $7,200 annually towards your copay and/or deductible if you have health insurance.

As many have found, when used to cover your PrEP prescription, within one or two months many patients find their deductible or out-of-pocket maximums have been met because the co-pay coupon counts towards those limits. From that point on, you might have low or zero out-of-pocket medical expenses.

But if the proposed rule is adopted, insurance companies could block those coupon payments from being applied towards a patient’s deductible and out-of-pocket maximums – even though the insurance company isn’t having to pay.

Why does an insurance company care where the funds come from as long as the bill gets paid???

In those cases, you would have to pay much more in regard to out-of-pocket spending before reaching your deductible.

And it’s not just HIV medications in play here.

The new policy could affect Americans with hepatitis B or C, who need daily medications to stay healthy in the case of hepatitis B, and for medications to cure hepatitis C which requires treatment for up to 12 weeks.

Donald Trump has said in the past he wants to lower the cost of prescription drugs, but this certainly won’t do the trick.

As the Blade notes, some patients with limited funds often skip a dose of medications here or there to stretch out the drugs they have. But studies have shown that missing just two days of HIV meds can increase an individual’s viral load.

It’s not just HIV or hepatitis patients that could be affected.

A study from the IQVIA Institute for Human Data Science shows in 2017 69 percent of insured Americans did not fill their new prescriptions when they had to pay more than $250 out of pocket. Such non-adherence leads to tens of thousands of preventable deaths each year.

In the end, while Trump may profess to want to help the American people with their healthcare costs, this new policy would only favor insurance companies.

Here’s hoping the new policy proposal is rejected.

(source: Washington Blade)

News Round-Up: October 11, 2018

Some news items you might have missed:

• The above graphic is dedicated to any and everyone considering National Coming Out Day… #comeoutcomeoutwhereveryouare

• Activists are warning people with HIV and other chronic illnesses to check small print when getting a new health insurance policy. Some insurers are refusing to allow co-payment assistance coupons from drug manufacturers from counting towards annual deductibles.

• Americans have ranked Barack Obama as the president who’s done the best job in their lifetimes.

• Observing the 20 anniversary since Matthew Shepard was kidnapped and beaten then left to die on a cold Wyoming night tied to a fence, his parents have announced his remains will be interred at the Washington National Cathedral later this month.

• The 750,000 citizens of North Dakota, where Democrat Sen. Heidi Heitkamp is struggling in the polls, could very well decide for the country who controls the Senate after midterm elections.

• UK recording artist (and Randy Report favorite) Calum Scott offers his own coming out story for National Coming Out Day.

Scott recounts a painful part of his young adult life – processing the complex emotions of being a gay teen and letting the world around him aware of his sexual orientation. Friends abandoned him early on, and it hurt. But in the poignant profile, he says he found the courage to be honest about himself through music.

New York State Will Investigate Claims That Insurance Companies Denied Healthy Gay Men Coverage

According to reports, some insurance companies appear to be denying insurance policies to gay men who admit to taking medication that protects them from HIV infection.

Wait – what? These are healthy guys who are taking preventative steps to avoid HIV infection and insurance companies are holding it against them?

Not only is that not cool, it’s also probably illegal.

From The New York Times:

Such denials would amount to illegal discrimination based on sexual orientation, and the companies doing so could be penalized, said Maria T. Vullo, the state’s superintendent of financial services.

The investigation was triggered by an article published Tuesday by The New York Times, she said.

The Times reported that various insurers around the country had denied policies to gay men after learning they took Truvada, a cocktail of two anti-AIDS drugs, to avoid catching H.I.V. through sex. To get insurance, some men even stopped taking the protective drugs.

The practice — known as “pre-exposure prophylaxis,” or PrEP — is recommended by the Centers for Disease Control and Prevention. Studies have shown that people who take the drug every day have nearly a zero chance of becoming infected, even if they are in a long relationship with an H.I.V.-infected person or have sex with many strangers without condoms.

The investigation was prompted by another story in the NY Times about a doctor who couldn’t get disability insurance because he admitted to taking PrEP.

Video Of The Day: Bill Maher On Economic Facts

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Bill Maher slams the Obama-hating 2016 Republican candidates a…
Watch: Bill Maher slams the Obama-hating 2016 Republican candidates at this week’s debate.Video by Occupy Democrats, LIKE our page for more!
Posted by Occupy Democrats on Saturday, September 19, 2015

Bill Maher pulls out facts in response to Republicans who say they want to “take our county back.”

Back to what, exactly?

I should note, and regular readers know this to be true, I’ve been saying exactly this for years now.

What Success Looks Like

This is what a successful presidency looks like:

• Our dependence on foreign oil is at a 20-year low — and declining
• Emissions have fallen to their lowest levels in 20 years
• Domestic auto production is at a 12-year high
• Health insurance costs are increasing at the slowest rate since the 1960s

Does anyone have a problem with any of that?

I didn’t think so…