Campaign Urges Congress to Pass H.R. 3742, Bipartisan Legislation to Secure Non-Profit Patient Assistance under ACA

WASHINGTON, D.C. (May 5, 2016) – A group of leading national patient advocacy organizations today launched the Marketplace Access Project (MAP), a patient advocacy movement dedicated to protecting non-profit insurance premium assistance for individuals suffering from chronic and life-threatening illnesses. Guidance from the U.S. Centers for Medicare and Medicaid Services (CMS) allows health insurers to deny coverage to patients enrolled in qualified Exchange plans by rejecting the premium assistance patients receive from non-profit charities. MAP is urging Congress to pass the Access to Marketplace Insurance Act (H.R. 3742), bipartisan legislation that would protect non-profit patient assistance and allow charities to continue to be charitable. 

“Patient assistance programs play a critical role in ensuring individuals living with chronic and life-threatening illnesses can pay their monthly insurance premiums, providing an important temporary safety net that can often mean the difference between life and death,” said Dana Kuhn, Ph.D., president and founder of Patient Services, Inc., the founding member of MAP. “By allowing insurers to reject non-profit assistance to patients enrolled in qualified Exchange plans, CMS is jeopardizing the health of vulnerable patients nationwide by keeping essential treatments and services out of reach for those who need them most. We urge Congress to pass H.R. 3742, which is a common-sense, bipartisan solution to help ensure Americans living with chronic conditions have access to the care they need.” 

On March 19, 2014, CMS issued federal guidance on third-party insurance payments for the new Exchange plans offered under the Affordable Care Act (ACA). In direct contradiction to the standard currently followed by Medicare, CMS failed to include non-profit charities on the list of acceptable premium arrangements for patients covered by qualified health plans. Insurers across 38 states are now citing this CMS guidance to deny coverage to patients by rejecting the premium assistance they were previously receiving from third-party charities, effectively undermining the intent of the ACA.

“Non-profit patient assistance programs help patients bridge the financial gap that their insurance does not meet, making it possible for them to receive often life-saving therapies. The inability to afford your insurance premium should not be the new ‘pre-existing condition’ that impedes a patient’s access to care,” said Marcia Boyle, president and founder of the Immune Deficiency Foundation (IDF), a member of MAP. “Thankfully because of non-profit patient assistance programs, patients can lead productive lives at no added cost to the public.”  

Marketplace Access Project (MAP) members include:

  • Alpha-1 Foundation
  • Dystonia Advocacy Network
  • GBS/CIDP Foundation International
  • Hemophilia Federation of America (HFA)
  • Hepatitis Foundation International (HFI)
  • Hope for Hemophilia
  • Immune Deficiency Foundation (IDF)
  • National Hemophilia Foundation (NHF)
  • Patient Services, Inc. (PSI)
  • Pulmonary Hypertension Association (PHA)
  • US Hereditary Angioedema Association (HAEA)

“For patients who cannot afford their insurance and are unable to access care, it is not only their health that suffers,” added Kuhn. “When care becomes prohibitively expensive for patients and their families, many lose their insurance or are forced to declare bankruptcy, while others enroll in government programs and visit hospitals for primary care, adding to uncompensated care costs that are often paid for with tax dollars.”

MAP urges Congress to pass H.R. 3742, bipartisan legislation introduced by Rep. Kevin Cramer (R-ND) that would require qualified health plans to accept premium payments from non-profit charity organizations that operate in compliance with the False Claims Act.

For more information on the Marketplace Access Project, visit www.marketplaceaccess.org

About MAP

The Marketplace Access Project (MAP) is a patient advocacy movement dedicated to protecting non-profit insurance premium assistance for individuals suffering from chronic and life-threatening illnesses. MAP supports the Access to Marketplace Insurance Act (H.R. 3742), bipartisan legislation that would secure non-profit premium assistance for patients enrolled in qualified health plans and help ensure health care coverage that works for everyone. For more information, visit www.marketplaceaccess.org, or follow MAP on Twitter (@AccessProjectUS) and Facebook (www.facebook.com/marketplaceaccess).

###