Melanie Rowen, a woman with multiple sclerosis living in San Francisco, appeared before the Assembly Committee on Health yesterday to talk about money — or rather, lack of it.
When she first found out she had multiple sclerosis, Rowen had health care insurance but her medication was still expensive. “My insurance plan required me to pay 30% of it,” Rowen said. “I couldn’t afford it, but I put it on credit cards.” As she watched her disease progress, she saw her bank account drain away and her health care debt pile up.
Assembly member Fiona Ma (D-San Francisco) hopes to prevent similar scenarios with AB 1800 which would establish a limit on annual out-of-pocket expenses for prescription medications for insured Californians.
“It is unconscionable to make people choose between the medical medications they need and food for their children,” Ma said.
“If AB 1800 were in effect now,” Rowen said, “I’d be spending $6,000 a year and no more, rather than this limitless amount. It’s just a bottomless pit, in a market where we have no bargaining power at all.”
Nick Louizos, director of legislative affairs for the California Association of Health Plans, said there were several troubling elements to the bill.
For one thing, “it turns the Independent Medical Review process on its head,” Louizos said. “There are amendments on the table, but we continue to be concerned about this part of the bill.”
And, he said, when small-group insurance doesn’t fully cover some medications and patients get them anyway, that could pump up premium prices for large employers.
“This bill goes beyond the federal [health care reform] law in key ways,” he said. “As this applies to large employers, it will increase premiums, and we don’t think it’s appropriate to apply this to large employers.”
The bill passed the Assembly Committee on Health with 12 aye votes, and now heads to Appropriations.