What is Bill 135. How would it help sickle cell patients

Annie J. Ross-Womack

Annie J. Ross-Womack is executive director of the Ohio Sickle Cell and Health Association. September is National Sickle Cell Awareness Month.

Sickle cell disease is an inherited, rare, painful, and debilitating disease that affects thousands of Ohioans.

Ohioans living with SCD are supported by a state program initiated in the early 1970s by legislation passed by the Ohio General Assembly. The Ohio Department of Health’s program includes a regional network of medical providers and support services whose participants administer rigorous newborn screening programs, counseling and education services, and coordination of care across the country. ‘State.

Now, Ohio lawmakers may soon pass legislation that could further help people living with SCD and others with chronic, life-threatening conditions.

After:A sickle cell patient becomes a strong advocate for the importance of blood donations

Sickle cell disease affects millions of people worldwide – approximately 100,000 in the United States. Sickle cell disease is particularly common in people whose ancestors came from sub-Saharan Africa; Spanish-speaking regions of the Western Hemisphere (South America, Caribbean and Central America); Saudi Arabia; India; and Mediterranean countries such as Turkey, Greece and Italy.

Normal and sickle red blood cells

There are several types of sickle cell disease. The specific type of sickle cell disease a person has depends on the genes inherited from their parents. People with sickle cell disease inherit genes that contain instructions, or code, for abnormal hemoglobin.

After:Children with sickle cell disease are living longer than ever, but as adults they struggle to get basic care

As a result, the red blood cells cannot supply enough oxygen to the organs, tissues and bones of the body. When this happens, people living with sickle cell disease experience disabling pain. As they age, serious complications arise in the brain, heart, lungs and other vital organs.

Currently, there is no cure for sickle cell disease. Most treatments focus on relieving episodes of pain and preventing complications and unseen damage to the body. Treatments include medication and blood transfusions and sometimes even stem cell transplantation. Some cutting-edge gene therapy treatments are also underway.

Annie J. Ross-Womack is executive director of the Ohio Sickle Cell and Health Association.  September is National Sickle Cell Awareness Month.

After:How to Submit Guest Opinion Columns to the Columbus Dispatch

Medicines to manage rare and chronic diseases such as sickle cell disease and related diseases are often expensive. People with high-deductible health plans have to pay higher copays and coinsurance costs. Their medications are likely on specialist-level formularies, which increases these out-of-pocket costs.

Columbus resident Habiba Bankston is one of thousands of Ohioans living with sickle cell disease. As an adult, she transitioned from pediatric sickle cell care to adult sickle cell care. Transition services from childhood to adult treatment are a critical time for all people living with sickle cell disease.

Bankston, like other adults with sickle cell disease, receives care from Nationwide Children’s Hospital in addition to services from Ohio State University Medical Center. Through healthy living, blood transfusions and medication adherence, Bankston lives strong with sickle cell disease.

For many patients, it would be impossible to obtain medication without the help of third parties such as charities, churches, and drugmaker assistance programs. Unfortunately, health insurance companies have created policies commonly referred to as co-pay accumulators, which prevent co-pay assistance from being applied to a cost-sharing requirement.

The irony is that insurers refuse to apply financial assistance to the patient’s co-payment; they end up being paid twice by taking the monetary value of the co-payment aid and the patient’s deductible obligation.

Franklin Myles of Hudson donates during a blood drive to the American Red Cross, Tuesday, Sept. 14, 2021, in Akron, Ohio.  The Red Cross is looking for more black donors because many black people have distinct markers on their red blood cells that make their blood donations ideal for patients with sickle cell disease

After:Children with sickle cell disease are living longer than ever, but as adults they struggle to get basic care

In addition, insurers use industry intermediaries called drug benefit managers to develop and use policies that shift the cost of patient medications from the insurance company to the patient. Currently, nine out of 10 health care plans in Ohio have copayment accumulator adjustment policies.

The Ohio Legislature is taking action to help patients with chronic and life-threatening illnesses. The Ohio House, by unanimous vote, recently approved House Bill 135, which would address quota accumulator policies. House Bill 135 will help families in Ohio reduce out-of-pocket expenses by allowing payments from third-party assistance programs or other financial assistance programs to count toward their deductible and coinsurance.

Ohioans living with complex conditions such as sickle cell disease, multiple sclerosis, HIV/AIDS and cancer are just a few of the people this legislation will help.

As House Bill 135 waits to be heard in the Ohio Senate, it’s critical that policymakers understand that the bill does not require insurers to cover new benefits, or discontinue insurance. use of generic drugs nor to refer patients to more expensive drugs.

After:From a debilitating disease to a ‘normal’ life, a new gene therapy treatment promises to transform a rare disease

This bill does not increase premiums; so far, 14 states have banned copay accumulators and more than 20 states are working on legislation. The data shows that premiums did not increase in the first states where the bans were implemented.

People living with sickle cell disease appreciate that the Ohio Department of Health and state legislators support our community’s newborn care, education, counseling and screening. We urge members of the Ohio Senate to pass House Bill 135 to continue supporting Ohioans struggling with chronic illness.

Annie J. Ross-Womack is executive director of the Ohio Sickle Cell and Health Association. September is National Sickle Cell Awareness Month.

Comments are closed.