Insurance and Real Estate Committee
JOINT FAVORABLE REPORT
Bill No.: SB-1003
AN ACT PROHIBITING CERTAIN HEALTH CARRIERS AND PHARMACY
BENEFITS MANAGERS FROM EMPLOYING COPAY ACCUMULATOR
Title: PROGRAMS.
Vote Date: 3/22/2021
Vote Action: Joint Favorable
PH Date: 3/9/2021
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Sen. Martin M. Looney, 11th Dist.
Rep. Jillian Gilchrest, 18th Dist.
REASONS FOR BILL:
The bill addresses the concerns from patients who rely on co-pay assistance by allowing it to
continue and be added to their deductibles. Many patients who suffer from chronic conditions pay
high out of pocket costs for medications and heavily rely on co-pay assistance. This bill protects
the affordability of medication for patients and protects them from co-pay accumulators.
RESPONSE FROM ADMINISTRATION/AGENCY:
Ted Doolittle, Office of the Healthcare Advocate agreed that a copayment accumulator
programs are unfair and harmful to consumers. However, insurers have a legitimate concern
that copayment assist programs steer patients into higher costing medications.
NATURE AND SOURCES OF SUPPORT:
Patricia Carroll, RN, MS, NPD-BC, RRT supports the bill because co-pay assistance
removes the financial burden off working families who rely on medical assistance.
Suzi Craig, Chief Strategy Officer, Mental Health Connecticut supports the bill as co-pay
assistance programs are critical for those who live with chronic conditions. It allows
individuals to reduce out of pocket expenses and increase affordability for medications.
However, co-pay accumulators prevent individuals from using co-pay assistance in their
deductibles which negates financial relief.
Laura Hoch, National Multiple Sclerosis Society supports the bill as a person with MS will
spend three times as much out of pocket as the average person. The medications for
treatment are very expensive and people often face a high deductible. This poses a serious
challenge for people and urged the passage of the bill.
Bryte Johnson, CT Government Relations Director, American Cancer Society Cancer
Action Network supports the bill as prohibiting cost-sharing for prescription drugs can cause
patients to skip dosages, split pills and stop taking their medication entirely. This can cause
serious health concerns and reduces the effectiveness of their treatment.
Michael Crain, MD, Radiology Chairman supports the bill and asked that third party
payments be applied to a patient's deductible.
Connecticut State Medical Society supports the bill as it is a first step in addressing the
detrimental impact of High Deductible Health plans and it provides a fair and equitable
solution.
Michael Finley, State & Federal Government Relations Advocate, Epilepsy Foundation
supports the bill as it will protect Connecticut citizen from precarious copay accumulator
programs. Copay assistance plays a critical role in in ensuring that epileptic patients have
access to afford medication.
Lindsay Gill, Associate Director of State Policy and Advocacy, American Kidney Fund
supports the bill because many patients depend on financial assistance for their specialty
medications. Accumulator programs make it difficult if not impossible for patients to adhere to
their treatments.
Matt J. Granato, LL.M., MBA, President & CEO, Pulmonary Hypertension Association
as copay assistance has been necessary for many patients even those who use generic
therapy in treating Pulmonary Hypertension.
Senator Martin Looney, President Pro Tempore, Connecticut General Assembly
supports the bill as Co pay accumulator programs use patients as hostages in a battle of
insurers, pharmacy benefit managers and pharmaceutical companies. He does not support
taking more money from patients.
Dr. Stephanie R. Paulmeno, Old Greenwich, CT supports the bill as it is a public health
issue when patients cannot afford medications. 1 in 10 Americans have a rare disease which
impacts 300,000 CT residents. Insurance companies and PBM programs reap the benefits
intended for patients.
Several Patient Advocacy Organizations support the bill as it is much needed to protect
patient access to co-pay assistance programs:
Alliance for Patient Access, Charles Husser
American Kidney Fund, Lindsay Gill
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 Arthritis Foundation, Steven Schultz
Association for Clinical Oncology, Allison Rollins
Chronic Care Policy Alliance, Lawrence LaMotte
Coalition of State Rheumatology Organizations, Brian Henderson
Connecticut Hemophilia Society, Meagan Murray
Connecticut Oncology Association, Dawn Holcombe
Epilepsy Foundation of Connecticut, Mike Finley
Global Healthy Living Foundation, Corey Greenblatt
Hemophilia Federation of America, Miriam Goldstein
HIV + Hepatitis Policy Institute, Carl Schmid
Susan G. Komen Foundation, Steven Raga
National Alliance on Mental Illness Connecticut, Lisa Winjum
National Eczema Association, Michele Guadalupe
National Hemophilia Foundation, Nathan Schaefer
National Psoriasis Foundation, Kristen Stiffler
New England Bleeding Disorders Advocacy Coalition, Joe Zamboni
New England Hemophilia Association, Rich Pezzillo
Pulmonary Hypertension Association, Katie Kroner
U.S. Pain Foundation, Cindy Steinberg
Richard Pezzillo, New England Hemophilia Association supports the bill as Hemophilia is
a rare genetic condition that without treatment can cause internal bleeding and other health
complications. Having coverage alone is not enough to cover medication costs and many
patients rely on copay assistance program to afford to live. Hemophilia is a condition that has
no generic alternative available making it a high cost condition. Five states have acted to
restrict copay accumulators and urged CT to do so.
Steven Schultz, Director, State Legislative Affairs, Arthritis Foundation supports the bill
and urged for reform regarding accumulator adjustment programs. This legislation is
important as mist patients are unaware, they are involved in the program until they must pay
full price for their medication leading to delay or abandonment.
Mark Zatyrka, New England Hemophilia Association, Patient supports the bill from his
own personal experience with Hemophilia. He has suffered from a lot due to the condition
and pays a lot for medication to be able to survive. Without medication the life expectancy is
30 years. He urged for the passage of the bill.
Jill Zorn, Senior Policy Officer, Universal Health Care Foundation of CT supports the bill
as high deductible health plans become more common patients with chronic disease are
challenged to afford their care. Patients rely on coupons and other discount programs to help
them afford their medications until they reach their deductible or hit their max.
NATURE AND SOURCES OF OPPOSITION:
The Connecticut Association of Health Plans opposed the bill because coupons are used
by pharmaceutical companies to induce patients to use brand name drugs instead of the
generic brands. This usually is paid back to the drug company and not the insurance carrier.
The passage of the bill will benefit drug companies at the long-term expense of consumers.
Page 3 of 4 SB-1003
Sam Hallemeier, Director, State Affairs, PCMA opposed the bill as pharmacy benefit
managers exist to make drug coverage more affordable by aggregating the buying powers of
millions of enrollees through their sponsor/ payer clients. PBM's help consumers obtain lower
prices through rebates and discounts. Drug manufactures steer patients into more expensive
brand drugs through coupons instead of a cheaper alternative. Copay coupons target only
those who already have prescription drug coverage and are not designed to help the poor or
uninsured.
Reported by: Christina Cruz Date: 04/05/2021
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Statutes affected:
Raised Bill:
INS Joint Favorable:
File No. 363:
Public Act No. 21-14: