AUGUSTA – Senate President Troy Jackson, D-Allagash, and Senator Ned Claxton, D-Auburn, unveiled legislation to improve coverage of prescription contraceptives and lower prescription drug prices at a virtual press conference on Monday alongside Planned Parenthood of Northern New England, AARP Maine, and Maine Consumers for Affordable Health Care. The bills build on previous efforts put forward by Senate Democrats to lower health care costs for working Maine families.
The first bill – LD 1954, “An Act to Ensure Access to Prescription Contraceptives” – sponsored by President Jackson, would require all state-regulated health care plans to cover all prescription contraceptive medications approved by the Food and Drug Administration at no out-of-pocket cost to patients.
“Patients also shouldn’t have to jump through hoops to get the medication or products that best meet their health needs, and insurance companies shouldn’t get to dictate the medication or medical products that Maine patients can access, especially for something as simple and as important as prescription birth control,” said President Jackson. “But unfortunately, the way our health care system is set up, we have drug companies, pharmacy benefit managers and insurance giants all fighting tooth and nail to make a profit on the backs of patients. That’s why I’ve introduced LD 1954. It’s about cutting bureaucratic red tape and putting patients first when it comes to prescription contraceptives.”
Insurance companies are required to cover at least one contraceptive product in each method category of contraception at no out-of-pocket cost to patients under the Affordable care Act. However, that does not mean companies are required to cover a patient’s preferred contraceptive product, as determined by a health care professional and the patient, so long as the plan covers another product within the same method category. The key issue is that prescription products that fall within the same method category of contraception often have meaningful differences (i.e. chemical makeup, hormone dosages, length of effectiveness). According to a survey conducted by the Kaiser Family Foundation, almost one in five patients say they are not using their preferred method of contraception, and a quarter of these individuals cite cost as the reason.
“As a health care provider, we can confirm that our patients in Maine have experienced many of these same denials. It is frustrating to prescribe a method that is best for a patient and then try to navigate the multiple denials and jump through hoops to get our patients the care they need,” said Nicole Clegg, Planned Parenthood of Northern New England. “The reality is that patients and clinicians should determine the best medication for themselves, not insurance companies. LD 1954 will put reproductive care decisions where they belong: back in the hands of patients and their providers.”
The second bill – LD 1636, An Act To Reduce Prescription Drug Costs by Using International Pricing – sponsored by Sen. Claxton, a retired family physician, would establish international reference rates for the 250 most costly drugs, so Mainers don’t pay more for prescriptions than what companies charge for the same drugs in Canada.
“As a family physician, my goal was to ensure that every patient who walked through the doors of my family practice got the care and medication they needed. However, the cost of prescription medication proved to be a real barrier for the working-class families in my area,” said Sen. Claxton. “There is no good reason that Americans pay more for prescription medication than our Canadian neighbors. This bill is an attempt to build off previous legislation to rein in prices and bring accountability to the prescription drug industry. I look forward to working with the committee to pass something that will deliver meaningful relief to Mainers all across the state.”
The high price of prescription medication has been a top concern for Mainers for years. A recent survey found that three out of four Mainers are concerned about the high price of prescription medication, and as many as one in three adults skipped a dose of medicine, cut pills in half or didn’t fill a prescription due to cost in the last year.
“The fact is Mainers are sick and tired of paying three times what people in other countries pay for the same drugs. Too often our office hears from Mainers who are making impossible choices between paying for the medicines they need and paying for other essentials like food and heat. We again thank Senate President Jackson and Senator Claxton for their leadership,” said Bridget Quinn, AARP Maine.
Prescription drug prices in the U.S. are 218 percent greater than prices in Canada. According to the Maine Health Data Organization, Mainers spent $170 million more on the 25 drugs that experienced the highest price increase last year than in the previous year.
“At Maine Consumers for Affordable Health Care (CAHC), we hear from people on a daily basis who are on the brink of financial ruin due to the cost of medication. All it takes is for the car to break down or a furnace repair bill to push people over the edge,” said Ann Woloson, Maine CAHC. “Mainers shouldn’t have to take drastic measures like skipping doses or cutting pills in half because they can afford their medication. LD 1636 will build on previous efforts to keep Mainers healthy and lower prescription drug prices.”
LD 1954 and LD 1636 come on the heels of new laws championed by Senate Democrats to improve drug price transparency, create a life-saving insulin program and establish the Office of Affordable Health Care. Senate Democrats have also introduced and passed laws to better regulate pharmacy benefit managers, established a wholesale prescription drug importation program, pending federal approval, and created the prescription drug affordability board.
Both proposals will be the subject of a public hearing before the Legislature’s Health Coverage, Insurance and Financial Services Committee tomorrow. The public hearing for LD 1636 begins at 10 a.m. The public hearing for LD 1954 begins at 1 p.m. The hearings can be streamed live here.