House Bills to Benefit Oregonians with Health Insurance Become Effective on January 1st

Four house bills benefitting Oregonians with health insurance will become effective on January 1, 2025.

Consumers Will be Able to Use Coupons Towards Deductibles

House Bill 4113 will allow consumers to use coupons and third-party discounts towards deductibles when paying for prescriptions, thanks to Oregon lawmaker, Rep. Emerson Levy, D-Bend, who sponsored the bill that will give consumers free rein to use discounts from pharmaceutical manufacturers – called co-pay assistance programs offered as a ploy to encourage people to buy their medications.

To date, commercial health insurers mostly disallow coupons and third-party discount offers towards deductibles, stipulating that consumers meet their annual deductibles before full coverage begins.

The Bill Will Give Consumers Leverage to Purchase More Expensive Medications

The bill will give consumers the leverage to select more expensive pharmaceuticals – some medications are not available in cheaper generic formats.

Levy explained that consumers have been restricted by the co-pay limiter programs, making their visits to pharmacies ‘a game of health care roulette.’

In the past, some patients stopped taking life-saving medications because of exorbitant costs, according to Jonathan Frochtzwajg, public policy manager for Cascade AIDS Project, a service provider for AIDS sufferers in Oregon.

He said for many, the only way they could afford medications was to use co-pay assistance to reach annual deductibles, but when these are not counted by insurance companies, it undercuts public health initiatives.

Pharmacists Can Provide COVID-19 Testing and Treatment

Senate Bill 1506 extends the period for pharmacists to provide COVID-19 testing and treatment services until June 30, 2026. Additionally, it mandates the Oregon Health Authority to compensate pharmacies for these services.

Health Insurers Will No Longer Stipulate Dispensing by Specialist Pharmacies

House Bill 4012 prohibits health insurers from stipulating that prescription drugs be dispensed by specialist pharmacies instead of the provider’s choice of pharmacy.

Starting January 1, 2025, House Bill 4149 mandates that pharmacy benefit managers obtain a license from the Oregon Department of Consumer and Business Services. Pharmacy benefit managers are middlemen in the prescription drug supply chain and help manage supplies between manufacturers, pharmacies and consumers.