Monday, May 9, 2016

Insurance companies beat rural Coloradans in pharmacy fight

Terri Newland of Basalt put a thermometer in her mailbox on Wednesday morning. It read 42 degrees. By 4 p.m. the thermometer had shot up to 104 degrees. By summer, those temperatures will be much higher. For her husband, who has diabetes and depends on mail-order insulin, that's dangerous.


That's why she wanted lawmakers to pass a proposal this week that would allow her and thousands of other rural Coloradans to go to their local pharmacies to refill daily medications.


But House Bill 16-1361 failed to gain support from the Republican majority on the legislature's Senate Finance Committee and died Friday.


Under the bill, patients - not insurance companies - would choose where to shop for medications. If a pharmacy falls outside of an insurance company's network, there would be no additional charges foisted on the patient. Out-of-network pharmacies would have to agree to the insurance company's reimbursements.


Newland's husband's insurance plan requires he purchase his insulin refills through a mail-order pharmacy.


Insulin has to be refrigerated. And waiting for those refills to show up in the mail puts her husband's health at risk, Newland told the Finance Committee last week. If the insulin sits for hours in their mailbox, it ruins it. Sometimes it takes weeks for those refills to show up, which also puts her husband's health in jeopardy. They recently found one of his prescriptions in a ditch.


Newland pleaded with the committee during the Thursday hearing to allow her to go to her local pharmacy to get those refills.


“This isn't a retail issue,” she said. “It's a matter of life and death.”


The measure's main opponent is ExpressScripts, the nation's largest company managing pharmacy benefits for insurance providers and subscribers. Lobbyist Patrick Boyle told the Finance Committee that passing the measure will drive up costs for health insurers and for their patients, too.


The bill drew intense lobbying on both sides of the issue when it went through the House. It passed the Senate State, Veterans and Military Affairs Committee on April 26 on a 4-1 vote, with Sen. Owen Hill of Colorado Springs in opposition.


But Hill also sits on the Finance Committee, where Republicans tossed up roadblocks on the bill. Hill told The Colorado Independent a “free-market solution” would be a better way of dealing with the issue, although he spent much of last Thursday attempting to find a solution with the the bill's sponsors, Sens. Jerry Sonnenberg of Sterling and Linda Newell of Littleton


Friday, Hill said he could not support the bill, but committed to Sonnenberg and Newell that he would make finding a solution a priority for next year. The bill died on a 3-2 party-line vote.


 


Photo credit: Rodrigo Senna, Creative Commons, Flickr

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