Rheumatology Leaders and Patient Advocates Convene on Capitol Hill Save

ACR members urged federal lawmakers to support the HELP Copays Act, Safe Step Act, and Improving Seniors’ Timely Access to Care Act.

Physicians and health professionals from the American College of Rheumatology (ACR) along with rheumatology patients gathered on Capitol Hill for the annual Advocates for Arthritis event to urge lawmakers to take action on a range of policy issues affecting patient access to rheumatology care. 

More than 90 advocates met with members of Congress and encouraged them to support bills that would reform insurer practices that often delay patients’ access to medically necessary treatment and increase patients’ out-of-pocket drug costs. Advocates also educated lawmakers on the increasing prevalence of rheumatic diseases, specifically arthritis, that are exacting a toll on Americans of all ages and backgrounds.  

“Coinciding with Rheumatic Disease Awareness Month, this event is an excellent opportunity for rheumatology advocates to connect with their Members of Congress and discuss the policy issues impacting patient care,” said Dr. Blair Solow, Chair of ACR’s Government Affairs Committee. “We look forward to continued collaboration with lawmakers on policy solutions that increase access to rheumatology care, minimize drug costs to patients and help more of their constituents live longer, healthier lives.”

ACR advocates asked lawmakers to support the following legislation to improve patient access to care:

• HELP Copays Act (H.R. 5801) – Introduced in the U.S. House by Representatives Donald McEachin (D-VA) and Rodney Davis (R-IL), this bill would require health plans to count the value of copay assistance toward a patient plan’s cost-sharing requirements. This would ensure that all payments, whether they come directly out of a patient’s pocket or from the help of copay assistance, counts towards their out-of-pocket cost calculation under their healthcare plan. Insurance companies are increasingly using copay accumulators to profit from the cost-sharing assistance patients receive from drug manufacturers, which ultimately shifts more of the cost of specialty medications onto patients.
• Safe Step Act of 2021 (H.R. 2163/S. 464) – Introduced in the U.S. House by Representatives Raul Ruiz, MD (D-CA) and Brad Wenstrup, DPM (R-OH) and in the U.S. Senate by Senator Bill Cassidy, MD (R-LA) and Maggie Hassan (D-NH), this bipartisan legislation would place reasonable limits on the use of step therapy in employer-sponsored health plans and create a clear process for patients and doctors to seek exceptions. The legislation builds on reforms passed in 33 states to address this practice that delays effective care and puts patients at unnecessary risk. While state efforts to limit insurer use of step therapy are an important step forward, Congressional action is needed to address the use of step therapy in employer-provided plans, which are regulated by federal law. Currently, there are 163 bipartisan co-sponsors in the House and 33 co-sponsors in the Senate.
• Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018) – Introduced in the U.S. House by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, MD (D-CA), and Larry Bucshon, MD (R-IN) and in the Senate by Senators Roger Marshall, MD (R-KS), Kyrsten Sinema (D-AZ), and John Thune (R- SD), this bipartisan legislation would make changes in Medicare Advantage to help standardize, streamline, and increase transparency in the prior authorization process. The legislation passed the U.S. House last week and advocates are urging the U.S. Senate to take up the bill by the end of this year. The legislation has 42 co-sponsors in the Senate.

See additional information about the ACR’s legislative priorities.