Trump proposals could increase health costs for consumers

A new Trump administration policy proposal to be published this week in the Federal Register could result in higher costs for consumers who use brand-name prescription drugs when cheaper alternatives are available. Health insurance plans sold under the Affordable Care Act would have annual limits on consumers' out-of-pocket costs.

A new Trump administration policy proposal to be published this week in the Federal Register could result in higher costs for consumers who use brand-name prescription drugs when cheaper alternatives are available. Health insurance plans sold under the Affordable Care Act would have annual limits on consumers' out-of-pocket costs. Under the proposal, insurers would not have to count the full amount of a consumer's copayment for a brand-name drug toward the annual limit on cost-sharing. Insurers would have to count only the smaller amount that would be charged for a generic version of the drug. In addition, insurers would not have to count the value of coupons and other financial assistance provided to consumers by drug manufacturers if generic alternatives were available. Economists say that coupons can raise health care costs by encouraging people to use more expensive drugs. "The availability of a coupon may cause physicians and beneficiaries to choose an expensive brand-name drug when a less expensive and equally effective generic or other alternative is available," the Trump administration said in explaining its proposal. "When consumers are relieved of copayment obligations, manufacturers are relieved of a market constraint on drug prices." Carl Schmid II, the deputy executive director of the AIDS Institute, said the administration's proposal could sharply increase out-of-pocket costs and increase the likelihood that people will not take their drugs.