Obamacare Out-of-Pocket Cost Delays A Bad Prescription for Consumers

by Gabriel Levitt, Vice President, PharmacyChecker.com and Sam Werbalowsky, Pharmacychecker.com | Aug 22, 2013 | Advocacy, Drug Prices, Healthcare Reform

Americans with high out-of-pocket healthcare costs will be disappointed with a new Affordable Care Act (Obamacare) delay announced by the Obama administration. The delay allows insurers and employers using more than one benefits administrator to wait one extra year – until 2015 – before being required to limit out-of-pocket costs to a maximum of $6,350 for an individual or $12,700 for a family, as mandated by the law. Instead, they will be permitted to maintain separate out-of-pocket limits for various benefits. For example, a patient may have a $6,350 cap for doctor visits and another $6,350 cap for prescription drugs.

Except that there may actually be no cap at all for prescription drug plans. Plans currently without out-of-pocket caps will not be subject to mandatory ones in 2014.

The only reason for the delay mentioned in a recent New York Times article is a technological problem. Many companies use different administrators for different benefits, and their computer systems are currently unable to combine all costs from different programs for a given patient. As the New York Times says, “In many cases, the companies have separate computer systems that cannot communicate with one another.” Companies need more time to upgrade their software to accommodate this.

Obamacare was passed in 2010, and the mandatory out-of-pocket limits were slated to go into effect in 2014, giving companies four years to figure out how to get their computers to talk to each other.

This does not seem like a legitimate reason to delay prescription drug spending caps. Fifty million adults did not fill a prescription last year due to cost; access to affordable medicine is a big problem in the United States, and failure to implement out-of-pocket spending limits will likely keep prescriptions unfilled.

Fortunately, safe international pharmacies offer low prices to Americans. As of last November, prices for brand name medication were 85% less expensive from them when compared to U.S. pharmacies. If you choose to order medication from abroad, make sure the pharmacy is a PharmacyChecker.com verified online pharmacy.