Bill Overview
Title: Emergency Advance Refill Notification Act of 2022
Description: This bill requires private health insurance plans that cover prescription drugs to notify plan holders about the plan's policy concerning advance drug refills in response to a national or public health emergency. Specifically, the plan must notify plan holders in emergency areas whether the plan is waiving time limits on authorized prescription refills and, if so, the process for obtaining an early refill. Plans must issue such notification within five days of an emergency being declared. Concerning the public health emergency declared in response to COVID-19, a plan must provide initial notification of its waiver policy not later than five days after this bill is enacted.
Sponsors: Rep. McBath, Lucy [D-GA-6]
Target Audience
Population: Private health insurance plan holders with prescription drug coverage
Estimated Size: 160000000
- This bill affects people who hold private health insurance plans that cover prescription drugs.
- The bill specifically targets plan holders who are in areas affected by national or public health emergencies.
- As many countries have been affected by COVID-19, the reach of this bill could be extensive globally.
- In the U.S., this applies to the entire population with private health insurance covering prescription drugs, which is a significant portion of the population.
- The bill requires insurance providers to inform plan holders about early refill policies during emergencies.
- Since it involves private health insurance and prescription refill policies, those without insurance or on public health plans like Medicare or Medicaid are not directly affected.
Reasoning
- The policy targets individuals with private health insurance plans covering prescription drugs.
- The primary beneficiaries are those affected by national or public health emergencies, e.g., individuals in areas declared to be under COVID-19 emergency.
- Participants may include diverse economic backgrounds, those heavily reliant on prescriptions, and people in high-risk health zones who benefit from early refills.
- The majority of participants have average insurance plans, but there are segments with high costs that may fall outside budget limits.
- KFF and census estimates guide the estimation of affected individuals, at roughly 160 million Americans, within an economized framework.
- The impact varies from none to high based on prescription dependence and perceived security during emergencies.
Simulated Interviews
Pharmaceutical Sales Representative (New York, NY)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 15/20
Statement of Opinion:
- I think a policy like this is necessary. During COVID-19, the uncertainty about medication refills was stressful.
- It's good that insurers need to inform us quickly as information is crucial during emergencies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Software Engineer (Los Angeles, CA)
Age: 31 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 18/20
Statement of Opinion:
- I don’t think this affects me much personally because I don’t use prescriptions regularly.
- But I see how it could be important for friends who rely on daily meds.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Retired (Houston, TX)
Age: 57 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 7.0 years
Commonness: 12/20
Statement of Opinion:
- I worry about running out of medication during emergencies, so this policy gives me peace of mind.
- Notification is key, but I hope it doesn't come with price hikes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 4 |
Student (Chicago, IL)
Age: 22 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 19/20
Statement of Opinion:
- I don't think I'll be directly impacted by this policy.
- It seems like something that would support people more reliant on medication than myself.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Teacher (Seattle, WA)
Age: 39 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 17/20
Statement of Opinion:
- Having clear information from insurance during emergencies helps ease worries.
- I hope insurers won't exploit this to delay service improvements.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Healthcare Worker (Miami, FL)
Age: 47 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 13/20
Statement of Opinion:
- A consistent refill system would ease my mind, especially considering occupational risks.
- It's a step forward, but needs more public awareness.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
Freelancer (Denver, CO)
Age: 29 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 11/20
Statement of Opinion:
- I’ve had issues accessing medication in the past, so I welcome this bill.
- Knowing I can get refills is reassuring in emergencies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 4 |
Small Business Owner (Phoenix, AZ)
Age: 64 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 10/20
Statement of Opinion:
- I'm worried about running out of medication, especially during emergencies.
- This bill offers a safety net, which is appreciated.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
Financial Analyst (Boston, MA)
Age: 34 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 16/20
Statement of Opinion:
- This policy sounds beneficial for those with regular prescription needs, not so much for me right now.
- I’m glad the option exists should I ever need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Marketing Manager (Atlanta, GA)
Age: 42 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- It's critical to receive these notifications promptly during emergencies.
- The policy should improve coverage transparency.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $200000000 (Low: $150000000, High: $250000000)
Year 3: $180000000 (Low: $140000000, High: $220000000)
Year 5: $150000000 (Low: $120000000, High: $180000000)
Year 10: $100000000 (Low: $80000000, High: $120000000)
Year 100: $1000000 (Low: $500000, High: $1500000)
Key Considerations
- Implementation costs for private health insurers.
- Frequency and duration of public health emergencies activating the notification requirements.
- Efficiency of existing communication infrastructure within health insurance companies.
- Potential long-term cost savings in healthcare management.