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ACA At 11: Lower Drug Costs

By March 19, 2021No Comments

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land and millions of people gained coverage and critical protections as a result. In addition to expanding coverage to more than 20 million Americans, the ACA improved health care affordability, particularly for patients purchasing prescription drugs. Between 2010 and 2018, the share of non-elderly adults with problems filling a prescription fell by 27 percent, while those with a problem paying a medical bill fell by 17 percent, the share who skipped a test or treatment fell by 24 percent, and the share who didn’t visit a provider when needing care fell by 19 percent.

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the health care law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. Making health insurance more affordable and accessible is especially important as the country continues to battle the coronavirus pandemic and millions have lost their jobs and their health insurance.

The ACA Included Key Provisions To Help Reduce Drug Prices: 

  • GAINED: Requirements that insurance companies cover prescription drugs. 
  • GAINED: Nearly 12 million seniors pay less for prescription drugs. 
  • GAINED: More than 60 million people gained access to birth control with no out-of-pocket fees. 
  • GAINED: Rules that increase competition in the prescription drug market and help Americans access cheaper drugs. 
  • GAINED: Consumer protections that prohibit drug companies from paying off doctors behind closed doors to influence the drugs they prescribe to patients.

Guaranteed Coverage Of Prescription Drugs. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and mental health treatment. 

Lower Drug Costs For Seniors. Because of the ACA, the Medicare prescription drug donut hole is closed. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

More Than 60 Million Gained Access To Birth Control With No Out-Of-Pocket Fees. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 62.4 million patients with no out-of-pocket costs. More than 99 percent of sexually-active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013.

Patients Have Access To Cheaper Drugs. The ACA’s Biologics Price Competition and Innovation Act paved the way for the Food and Drug Administration (FDA) to approve biosimilars, cheaper alternatives to expensive biologics. This provision is projected to save $54 billion between 2017 and 2026.

Drug Companies Are Barred From Paying Doctors Behind Closed Doors (To Prescribe Drugs You Don’t Necessarily Need). Thanks to the ACA’s Physician Payments Sunshine Act, Big Pharma can no longer make payments and offer gifts to doctors behind closed doors. When these payments are made with no transparency, they can create conflicts of interest and blur the line between objective and promotional research.