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Congress leaves insured Americans at the mercy of Pharma and out-of-control drug costs

Written by Diane Archer

Let’s face it, HMOs and PPOs are playing a game of bait and switch, keeping monthly premium increases down while raising their members’ out-of-pocket costs. Avalere reports that specialty drug costs are no exception with more than four out of ten state health exchange “silver” plans and more than half of the “bronze” plans requiring members to pay at least 30 percent of their cost in 2015. For many people with life-threatening illnesses who rely on these expensive drugs, this jeopardizes treatment. (And, costs for critical generic drugs also can be prohibitive.)

The health plans are culpable mainly because they would rather shift costs to their members than admit they are powerless to contain prices. Consequently, they won’t join forces with their members and call upon Congress to ensure drug prices are reasonable. They won’t risk getting on the wrong side of lawmakers who are beholden to the drug industry. They do this knowing full well how important drugs can be for people with cancer, multiple sclerosis and myriad other complex conditions—and that high coinsurance could be a death sentence for those who can’t afford it.

It is a gross injustice for Congress to allow health plans to leave people with serious and disabling conditions at the mercy of out-of-control drug costs rather than rein in prices, as every other industrialized nation does. People need to be able to budget for their care up-front. Their premiums should be seen as ample contribution to the cost. Insured people should not be forced to go without critical medications.

Of course, when you follow the money and the lobbyists, as the Center for Responsive Politics and Pro Publica have done, you see very quickly why Congress supports what’s best for the pharmaceutical industry, not ordinary Americans.



  • Ever since our president was inaugurated, this congress has done nothing except obstruct. The Republicans do not care about their party, their country or their constituents. They only care about themselves and they live in fear of the, far right wing, Tea Party. These Teapublicans do not worry about what they pay for medications, as they have a gold star health plan, but what about the rest of us who are held hostage by Big Pharma and the health insurance industry.
    No other nation pays what we do for medications, nor do they worry about greedy insurance companies. Most industrialized nations have a national health plan and if insurance companies are involved, they are strictly regulated.

  • Medicare Part D the prescription drug plan, is not allowed to negotiate prices with the drug companies so the drug companies can charge what they want to and Medicare has to pass the increases on. It’s called Screw the Seniors. I’ve been on Part D since the beginning, my base co-pays have nearly doubled, and many of my prescriptions have been re-classified to a higher tier level which increases the cost dramatically.

      • Without the ACA you would be paying alot more…..
        Insurance increases over the past few years have skyrocketed.
        Don’t blame the ACA on the increase. Look at the history and you will see why.

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