Wisconsin All Copays Count Coalition Commends Governor Evers for Including “All Copays Count” Legislation in Budget, Again

The All Copays Count Legislation Would Ensure Wisconsin Health Plans and Pharmacy Benefit Managers (PBMs) Count Copay Assistance Towards Patient Cost-Sharing Requirements, Policy 16 States and Puerto Rico Have Already Enacted

MADISON, WI, February 16, 2023 – On behalf of more than 40 national and Wisconsin-based advocacy organizations that make up the Wisconsin All Copays Count Coalition we commend Governor Tony Evers for including critical “All Copays Count” legislation in his 2023-2025 Executive Budget Bill. In the Wisconsin legislature, bipartisan “All Copays Count” legislation (LRB-1933), led by Senator Andre Jacque and Representative Paul Tittl will be introduced for the third time.

Removing copay accumulator adjuster policies from insurance policies is vital to patients and would eliminate a major barrier to patient care. Insurers in Wisconsin and across the country are implementing harmful copay accumulator policies that don’t count the value of copay assistance toward a patient’s annual deductible or out-of-pocket maximum. These policies allow health plans to increase their profits by requiring patients to pay the same amount twice to get closer to their annual out-of- pocket limit, essentially double dipping into copay assistance meant for patients in need. A 2022 report from The AIDS Institute found that 8 out of 13 commercially available insurance plans in Wisconsin are implementing copay accumulator policies.

“As with the bipartisan group of Wisconsin lawmakers who are reintroducing this legislation, we commend Governor Evers for continuing to push this common sense solution to protect patients from harmful insurer policies designed to maximize the financial benefit for insurers at the expense of patients.” said Rob Gundermann, President and CEO of the Coalition of Wisconsin Aging and Health Groups (CWAG) and Chairman of the Wisconsin All Copays Count Coalition.

It is important to note, just like LRB-1933, the Governor’s budget proposal does not steer patients toward brand name drugs. The budget bill and LRB-1933 both contain language that states that it only applies for a prescription drug “that has no medically appropriate generic equivalent.”

To date, 16 states and Puerto Rico have passed legislation that requires health insurers to count the value of copay assistance towards patient’s cost-sharing responsibilities, including Arizona, Arkansas, Connecticut, Delaware, Georgia, Illinois, Kentucky, Louisiana, Maine, New York, North Carolina, Oklahoma, Tennessee, Virginia, Washington, and West Virginia.

More information about copay accumulators and the Wisconsin All Copays Count Coalition can be found at: https://www.wi4patients.com/