20.04.2024

Lawmakers Debate Bill To Prevent Insurance From Changing Prescription Coverage

State lawmakers have made the rising cost of prescription drugs a top priority this legislative session.

The latest bill would ensure that when you sign up for a plan that covers your medicine, you don’t have the rug pulled out from under you.

Kristin Stathis among those testifying in favor of the drug, “Our whole lives were totally turned upside down.”

She told lawmakers that her husband was diagnosed with a rare disorder that caused his body to stop producing blood.

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His doctor prescribed a medicine that was keeping him alive when suddenly the couple’s insurer changed the medication.

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Kristin Stathis

“For them to be able change a medication without even consulting our doctor first, that could totally effect the way his treatment went, I don’t understand it. Thank goodness our doctor was our advocate and called the insurance company and insisted something change and was able to go back”, said Stathis.

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Rep. Jonathan Singer, a Democrat representing Longmont, says insurers should hold up their end of the contract.

“A deals a deal”, said Singer, “and when people sign up for insurance and they have life-saving medications they should be able stay on those life-saving medications as long as they are signed up for that insurance.”

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Rep. Jonathan Singer

Singer and Rep. Daneya Esgar, a Democrat representing Pueblo, are sponsoring a bill that would bar insurers from changing medications or coverage in the middle of plan year.

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Rep. Daneya Esgar

“You sign up for a plan with expectations. You find something that works for you that you can afford and finding out midway through that’s switching on you, can be a scary thing”, said Esgar.

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Rep. Susan Beckman

But critics like Rep. Susan Beckman, a Republican representing Arapahoe County, say the bill is too restrictive.

“I agree that the physicians should be notified if your drugs are changed. I’m very concerned that their locking into a drug and they’re not giving any options for changing that for the long term. There’s no time-line on this”, said Beckman.

She says sometimes less expensive drugs or new drugs may work just as well or even better.

But Ron Pierre – who has Lupus – told lawmakers that his insurer didn’t listen to his doctor until he ended up in the hospital.

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Ron Pierre

“My temperature went up to 107, which I almost died. It just doesn’t make any sense. Why not stay on what works?”

After several hours of testimony, the House committee that heard the bill postponed a vote while they work on amendments. The legislation is one of ten bills this session that have tried to address the high cost of prescription drugs.

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