A new study commissioned by the Pharmaceutical Researchers and Manufacturers of America (PhRMA) finds that many consumers in ObamaCare’s insurance exchanges will end up paying more than twice as much in out-of-pocket drug costs.
The report was conducted by actuarial firm Milliman, found that people on the Silver Plan, which is the most popular ObamaCare plan, would likely pay 130% more for out-of-pocket prescription drugs compared to people on similar employer-sponsored plans.
Recently S&P Capital IQ predicted up to144 Million Americans will lose their employer plans once the employer mandate kicks in next year and forced onto the Obamacare exchange.
the report concludes that Silver plans with combined deductibles impose
130 percent higher cost sharing for prescription medicine than typical
employer-sponsored plans, compared to about a 20 percent increase for
other health care services for members without subsidies that previously
had typical employer coverage.
Studies have found that higher out-of-pocket costs reduce patients’
likelihood of taking prescription medicines to manage chronic
conditions. The result is an increase in hospitalizations and higher
health care costs overall. Conversely, programs that encourage better
adherence have the potential to reduce emergency department visits,
hospitalizations, and other preventable, costly care. In fact, according
to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.
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“Medicines are one of the most significant contributors to improved
quality and length of life for people with serious diseases, such as
chronic illnesses, cancer, and HIV/AIDS,” said Castellani. “To improve
health and, in turn, control health care costs, we must continue to work
toward a health care system that improves access and adherence to
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participating in the Exchanges were promised coverage comparable to
employer plans and yet the reality is that many new plans are failing to
provide an appropriate level of access to quality, affordable health
care,” said John Castellani, President and CEO of PhRMA. “Patients face
hurdles in accessing the medicines they need to manage their conditions,
which is particularly problematic for Americans trying to control their
The Milliman report also noted that Silver plans are nearly four
times more likely to have a single combined deductible for medical and
pharmacy benefits (46 percent of the time) compared to typical
employer-sponsored plans (12 percent of the time). This is an important
distinction, particularly for patients with chronic illnesses, as it
means prescription medicines are not covered until patients meet the
deductible. According to Milliman’s analysis, the typical deductible for
Silver plans is $2,000. Previous research from Avalere Health found
that in the lower-cost Bronze plans, deductibles are even higher,
averaging more than $4,000.
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