Bill would bring relief on drug costs

More Minnesotans than ever rely on prescription drugs to manage diseases that once were fatal or debilitating. These drugs can be lifesaving, but often come with price tags that can prove disruptive to care. One study found 4 out of 10 cancer patients abandon their treatment when it costs more than $2,000.

As a small-business owner in Bemidji and a health care provider in Rochester, we understand the different sides of these challenges. What brings us together today is our enthusiasm for a legislative proposal that makes drug costs more manageable for some Minnesotans without hurting coverage for others.

SF 365 and HF 633 are bipartisan bills that would require Minnesota insurers to offer a "copay-only" drug coverage option for a small portion of their individual and small-group health plans. People who choose this option would have their prescription costs spread out across the year, instead of facing massive deductible and coinsurance bills at the start of the year.

These patients would still pay their expected share of their care costs. And Minnesotans who don't want this kind of coverage wouldn't see any changes in their plans. The bills have the support of 23 patient advocacy, medical, pharmacy and public health organizations representing voices across the state.

If this proposal sounds too good to be true, it's not. The Minnesota Department of Commerce conducted a detailed review of the impact this legislation would have on Minnesota consumers and health plans. The department confirmed at a Feb. 9 hearing that this proposal would improve public health and economic stability for patients by making it easier to afford medications and stay on them, and with no financial impact to people choosing to buy other kinds of coverage.

This is a sensible idea, but it's hard for insurers to do it on their own. If a solitary insurer steps forward to do this, they will attract more customers with health problems compared to their competitors, and they'll be at a competitive disadvantage. This is what happened in Colorado when the state adopted a voluntary model in the middle of the last decade: Colorado found success with copay-only plans in 2018 when it required all insurers to participate. With all the insurers at the table, everyone shares in the risk and the concept works for everyone.

Frankly, insurance companies have stood in the way. When the bill came forward last year, insurers asked state lawmakers to first analyze the impact of the bill. That was a fair request. But even since the department's analysis came back — again, showing the copay-only model would work without impacting other Minnesotans who buy their own coverage — insurers remain privately opposed and refuse to state their concerns in public where all sides could sort through the facts and seek consensus.

Without legislative action, Minnesota will soon become one of just a handful of states without a copay relief option for consumers on the individual market. Colorado is one of 11 states that have adopted some form of copay relief law, and changes at the federal level are poised to bring similar options to 30 more states in 2023.

There is still time for Minnesota Senate and House leaders to pass these bills, especially if they agree to include this provision in the reinsurance bill being negotiated this month. But the clock is ticking in St. Paul.

Tom Vanderwal, of Bemidji, is program director of Greater Northwest Emergency Medical Services. Andrew Herber, of Rochester, is a physician assistant at the Mayo Clinic. The views expressed here are solely the authors'.