Letter Introduced by Reps. Kevin Cramer (R-ND) & Doris Matsui (D-CA) Seeks to Protect Quarter of a Million Americans Who Depend on Charitable Assistance for Access to Critical Healthcare

WASHINGTON, D.C. (May 31, 2017) – The Marketplace Access Project (MAP), a group of leading national patient advocacy organizations dedicated to protecting non-profit insurance premium and cost-sharing assistance for individuals suffering from chronic and life-threatening illnesses, today applauded 184 members of the U.S. Congress for their letter urging Department of Health and Human Services (HHS) Secretary Tom Price to protect non-profit patient assistance by modifying a rule by the U.S. Centers for Medicare and Medicaid Services (CMS) allowing health insurers to deny coverage to patients who receive premium and cost-sharing assistance from charitable organizations.

“Nonprofit patient assistance organizations provide vital services to Americans who suffer from rare and chronic conditions,” the members of Congress wrote. “These organizations serve as a safety net for those most in need, enabling access to life-sustaining and life-saving therapies while preventing individuals and families from experiencing financial crises, such as bankruptcy and home foreclosures.”

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 and cost-sharing arrangements for patients covered by qualified health plans. Insurers across 41 states are now citing this rule to deny coverage to patients by rejecting the premium and cost-sharing assistance they were previously receiving from third-party charities, effectively undermining the intent of the ACA. The bipartisan letter led by Reps. Kevin Cramer (R-ND) and Doris Matsui (D-CA) and signed by 184 members of Congress calls on HHS Secretary Price to issue an administrative fix for the CMS guidance on third-party payments and require health insurance companies to accept payments from non-profit charity organizations that operate in compliance with the False Claims Act.

“184 members of Congress have taken a laudable stand for the quarter of a million Americans who depend on charitable patient assistance to survive,” said Dana Kuhn, Ph.D., president and founder of Patient Services, Inc., the founding member of MAP. “With health insurance costs on the rise, charities that provide premium and copayment assistance are needed now more than ever to ensure chronic patients receive adequate care. We urge HHS to listen to the mounting support for this effort both in Congress and across the country and immediately override CMS’s harmful guidance so that the most vulnerable Americans can continue to receive access to life-saving health care.”

“At no added cost to the public, non-profit patient assistance programs serve as a critical lifeline for individuals living with devastating diseases. Under CMS’s guidance, many patients who don’t qualify for public health plans are having to make the impossible choice between forfeiting their homes and staying healthy,” said Lisa Butler, executive director of GBS/CIDP Foundation International, a member of MAP. “It’s time for the administration to issue a long-overdue fix for this misguided rule.” 

To read the full letter, click here.

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 and cost-sharing assistance for individuals suffering from chronic and life-threatening illnesses. For more information, visit www.marketplaceaccess.org, or follow MAP on Twitter (@AccessProjectUS) and Facebook (www.facebook.com/marketplaceaccess).