Rising health care costs continue to be a challenge for patients and their families in the commonwealth of Virginia and across the country, particularly those living with rare and chronic conditions. Unfortunately, a safety net that has helped provide patients access to care is being threatened, and action is needed from Virginia’s legislators to ensure patients have access to life-saving treatments and services.
Nonprofit charitable assistance is a vital health care safety net for many patients and their families. They rely on it to help afford their care and often have no other options—charitable assistance is their last resort.
But a misguided policy from the Centers for Medicare and Medicaid Services (CMS) does not include nonprofit charities on the list of entities that can provide third-party assistance for patients, many of whom are battling rare, chronic and life-threatening illnesses. As a result, insurers in Virginia and 41 other states are allowed to deny coverage to patients simply for receiving charitable assistance to pay their health insurance premiums and copayments. This regulatory guidance puts the most vulnerable patients at risk of being unable to afford the care they need, keeping essential treatments out of reach.
The situation is dire for patients with rare, chronic and life-threatening illnesses that rely on innovative, life-sustaining medications and who occasionally turn to charities after a job loss or similar hardship to ensure there is no catastrophic disruption in access to care.
Patients in Virginia living with illnesses such as hemophilia, cancer, HIV/AIDS and other conditions often face higher insurance premiums just to keep the health coverage they need to manage their conditions. The cost of care can be prohibitive for many patients and their families, often forcing them to make difficult financial choices, such as choosing between taking their medication or paying rent.
Fortunately, charitable assistance organizations like Virginia-based Patient Services, Inc., provide financial support to patients to ensure access to treatments they need. These organizations provide support and guidance for patients through nonprofit premium and cost-sharing assistance programs that help alleviate financial pressures. Because this assistance comes from charitable donations, and not taxpayer dollars, patients receive help at no added cost to the public.
As policymakers consider solutions to lower health costs, they should not take any action that jeopardizes the availability of charitable assistance to the patients who have no other options.
No one chooses to be diagnosed with a devastating illness. But we can help prevent potentially fatal consequences for these patients by protecting charitable assistance and the health care safety net. I thank past champions like U.S. Rep. Rob Wittman, R-1st, and urge new members like U.S. Rep. Abigail Spanberger, D-7th, and the rest of the Virginia congressional delegation to support bipartisan legislation to ensure that those who need charitable assistance can access the critical treatments and services they need.
It’s time for lawmakers in Virginia to protect patients—and let charities be charitable.