Obamacare Spurs Merck, Glaxo to End Co-Pay Aid

[Yo_Mama]

Please note that the title is a bit of a misrepresentation. It is not so much ACA as a statement by CMS (regulatory rather than law, but regulators do make the law):

http://www.bloomberg.com/news/2014-03-26/obamacare-causes-merk-glaxo-to-end-co-pay-assistance.html

Abandoning a long-held industry tradition, GlaxoSmithKline Plc and Merck & Co. won’t help low-income Obamacare patients pay for their high-priced drugs.

The drugmakers say they won’t provide the assistance until the government decides whether programs overseen by the U.S. health-care act are subject to federal laws banning kickbacks that steer business to companies. So far, U.S. agencies have sent mixed messages on the issue, industry officials said.

Nor has this issue suddenly emerged - insurance companies have been lobbying hard to stop these programs because it increases their costs - they impose higher copays to stop patients from using these drugs, and the pharmaceutical companies help the patients so they can keep using them.

However this is an area in which regulatory rulings may make ACA policies less of "insurance" then non-ACA policies, so it should be watched. The struggle over copays is partially in court, but non-ACA policies still allow the copays. CMS issued a "guidance" trying to get this practice stopped:
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/third-party-qa-11-04-2013.pdf

CMS regulates ACA policies but not standard private insurance.

Here's a background link about this not really beginning with ACA.
http://www.fiercepharma.com/story/express-scripts-stops-covering-key-big-pharma-drugs-cost-effectiveness-grou/2013-10-10

Please note that such assistance from pharmcos is used by a wide range of privately-insured patients to get access to treatments. The attempts to stop the practice effectively deny care to lower income individuals.

[Supersedeas]

1. these sort of unintended consquences are likely to pop-up all over the place

[Skidmore]

2. If these companies can sell their wares in other nations at considerably cheaper prices, then

that is the expectation that should be set for this nation. The question really is how to wean the executive class from high bonuses and get their salaries in some reasonable proximity to what they are willing to pay their employees.

[yeoman6987]

3. I must not understand the problem

The reason that drug companies gave the poor these drugs is because they could not afford insurance. Now that everyone will have insurance they don't need to provide drugs to the poor anymore. This is really good news in the long run. It means that Obamacare is working for everyone.

[Yo_Mama]

4. No, it's assistance for those whose insurance covers too little of the cost

There are copays. And for some a window until coverage kicks in.

The drug companies have been picking up part of the costs for those who can't afford the drugs even WITH insurance, and now some are beginning to terminate that for those who have ACA policies. It's developing.

Like William Pitt's wife - she has insurance, but they won't cover an MS drug. So he got it from the pharm company. That sort of thing. When your cost for a drug with insurance is $600 or even $200 a month, a lot of patients can't get the drug.