ABOUT THE BILL

The HELP Copays Act (H.R. 830, S. 1375) addresses the issue of out-of-pocket expenses for health insurance enrollees by mandating that insurance plans apply various forms of financial assistance toward cost-sharing requirements. Specifically, the bill requires that third-party payments, financial assistance, discounts, product vouchers, and other forms of cost reduction be credited towards the enrollee’s share of costs, such as deductibles, copayments, and coinsurance. This provision aims to reduce the financial burden on individuals who rely on such assistance to manage their healthcare expenses.
By ensuring that all forms of financial aid and discounts are accounted for in meeting cost-sharing requirements, the HELP Copays Act seeks to make healthcare more affordable for patients. This measure will help alleviate the financial strain on those who may otherwise face high out-of-pocket costs despite receiving assistance or discounts. Ultimately, the bill is designed to improve access to necessary medical care and reduce the financial barriers that can impede individuals from obtaining the treatments and services they need.

CURRENT SITUATION & ISSUE

In the current healthcare system, patients often face significant out-of-pocket expenses despite receiving financial assistance, discounts, or third-party payments. Health insurance plans frequently do not apply these forms of financial aid towards cost-sharing requirements such as deductibles, copayments, and coinsurance. As a result, individuals may still struggle with high healthcare costs even when they have financial support or discounts, making it challenging to access necessary medical treatments and services.
This issue can lead to financial strain for patients who need ongoing care and may contribute to inequities in healthcare access. The lack of uniformity in how financial assistance is applied can cause confusion and hardship, particularly for those managing chronic conditions or requiring expensive treatments. Consequently, individuals may delay or forgo necessary care, impacting their overall health outcomes and exacerbating financial burdens.

HOW THE BILL FIXES IT

The HELP Copays Act directly addresses the problem of inadequate application of financial assistance towards cost-sharing requirements by mandating that health insurance plans apply various forms of financial aid to out-of-pocket expenses. Specifically, the bill requires insurance plans to credit third-party payments, financial assistance, discounts, product vouchers, and other reductions towards the enrollee’s cost-sharing obligations such as deductibles, copayments, and coinsurance.
By ensuring that these forms of assistance are accounted for in meeting cost-sharing requirements, the bill helps to reduce the financial burden on patients. This means that individuals who receive financial aid or discounts will have those contributions directly applied to their healthcare costs, leading to lower out-of-pocket expenses. The bill aims to improve the affordability of care, making it easier for patients to access necessary treatments and services without facing unexpected financial obstacles.

WHAT IT SEEKS TO DO

The HELP Copays Act seeks to improve the affordability of healthcare by ensuring that various forms of financial assistance and cost reductions are applied toward patients’ cost-sharing requirements.
The bill mandates that health insurance plans must credit third-party payments, financial assistance, discounts, product vouchers, and other forms of financial aid directly to an enrollee’s cost-sharing obligations, such as deductibles, copayments, and coinsurance.
By doing so, the bill aims to alleviate the financial burden on individuals, making it easier for them to manage their out-of-pocket healthcare expenses and access necessary medical care.
• Third-Party Payments: Requires insurance plans to apply payments made by third parties towards cost-sharing requirements.
• Financial Aid and Discounts: Mandates that financial assistance, discounts, and product vouchers be credited to out-of-pocket costs.
• Cost-Sharing Obligations: Ensures that all forms of financial aid reduce deductibles, copayments, and coinsurance.
• Improved Affordability: Helps lower overall healthcare expenses for patients.
• Barrier Reduction: Eases financial barriers, making it more feasible for patients to obtain necessary medical treatments and services.
• Financial Relief: Provides financial relief by ensuring that assistance and discounts are effectively utilized.

HOW THIS LEGISLATION BENEFITS OUR COMMUNITIES

NEXT STEPS TO ADVOCATE FOR IT

1.

Find the Legislation and Check the Status
To begin your advocacy efforts, it’s essential to know the current status of the bill. This involves identifying the bill numbers and checking the progress which you can do by clicking on the button below which will take you to our “Search & Track Legislation” page. Understanding where the bill stands—whether it has been introduced, is in committee, or is up for a vote—will help you tailor your advocacy efforts accordingly. Okay now don’t close the tab with this open, you will need it for step 3.
FIND THE BILL

2.

Find & Get Contact Info For Your Representatives
Identifying your federal and state representatives is crucial for targeted advocacy. You can use our “Find Your Representatives” page by clicking the button below to find your representatives’ contact information, including their phone numbers, email addresses, and office locations.
FIND YOUR REPRESENTATIVES

3.

Check If Your Representatives Are Cosponsoring the Bill
Cosponsoring means that a representative or senator has added their name in support of the bill, indicating their endorsement and helping to build momentum for its passage. Remember that page from step 1 that you pulled up with the information about the bill? That is where you can also look up your representatives on the bill’s page to see if they are listed as cosponsors. If they are already cosponsors, then you don’t need to do anything since they already support it, (if you want to though you thank them for their support). If they are not co-sponsors, then continue on through the steps which will help guide you to encouraging them to become cosponsors.
CHECK COSPONSORSHIP

4.

Create A One-Pager
Now that you know that your representative is not already supporting this bill, you can create a one-pager prior to contacting them so that you have it ready to go should you need it quickly. If you have not heard of a one-pager before, a one-pager is a concise document summarizing the key aspects of the bill. This should include a brief summary of the bill, its benefits, relevant statistics, and a personal story to humanize the issue. The one-pager should also contain a clear call to action, specifying what you want the reader to do. It might seem intimidating, but don’t worry we created a template and guide over on our one-pager page which you can access by clicking the button below.
CREATE A ONE-PAGER

5.

Contact Your Representatives
Now that you have all the info and one-pager, it is time to contact your representatives! You can learn all about this process and access resources and guides as to what to do on our, “Contact Your Rrepresentatives” page by clicking the button below. You can prepare your talking points using your one-pager, then reach out to your representatives via email, phone calls, or by scheduling a meeting. You can then explain why this bill is important to you, how it impacts you or those you care about, and request their support. You can then provide them with your one-pager for them to have and reference after.
CONTACT YOUR REPRESENTATIVES

6.

Share About The Bill On Social & Mainstream Media
Personal stories can be powerful advocacy tools. You can use our social and mainstream media toolkits to help you share about the bill, about your own experiences with the issue and how the passage of the bill would improve your healthcare. You can then go on to highlight the broader impact on patients with chronic, complex, and rare diseases. You can do this on social media as well as mainstream media to help make others aware of the legislation. While sharing about it, you can also provide resources, like this page, to help them each take action with their own representatives. This can help to get more representatives involved and move the process of the bill getting passed forward.
MEDIA TOOLKIT