The Business Council of New York State is not supporting legislation that seeks to amend the pharmaceutical law governing the purchase of prescription drugs.
The proposed bill, S. 2530 (Golden)/A. 6194 (Joyner), would undo the Anti Mandatory Mail Order (AMMO) law passed in 2011 to ensure patients had the option to choose a local or mail order pharmacy in their network based on their needs.
The New York Assembly passed its version of the bill, and the Senate Insurance Committee is currently reviewing S. 2530.
In New York, pharmacy benefits are optional and the cost of a pharmaceutical rider plays a major role in an employer’s decision to provide prescription coverage to employees. The Business Council believes S. 2530/A. 6194 will undoubtedly cause pharmaceutical costs to increase for New York consumers by reducing the number of employers offering prescription coverage.
“I think it is important to note that we are as a state facing significant increases in the coming year in (costs) for health insurance,” Lev Ginsburg, director of Government Affairs for The Business Council, told American Pharmacy. “The insurance companies for good reason have asked for significant increases in their rates in the coming years and the reasons are, of course, that expenses are ever climbing and outpacing just about everything.”
Since employers pay the bulk of prescription costs, recent provisions have presented challenges for businesses, Ginsburg said.
“We just saw a very, very significant increase in minimum wage -- a gigantic increase in minimum wage -- and the addition to a mandatory paid family leave program, and ... employers are very, very sensitive to further costs,” he said.
Ginsburg said he finds it surprising that S.2530/A.6194 is neglecting to take increased health care costs more seriously and not doing more to control them.
“What you are essentially doing is undermining pharmaceutical networks," he said. "But when you look at it as something that truly affects costs of pharmaceutical networks, any way you cut it, (it) significantly controls costs for pharmaceuticals for the consumer and these bills really just increase costs without increasing any kind of care for a person who has health insurance."
Provisions in the law protect consumers who are unable to access particular drugs in particular ways, but a bill like S. 2530/A. 6194 spikes health care costs and premiums, Ginsburg added.
“Beyond employers, employees have taken on a significantly greater role in paying for portions of their own premiums, co-pays, etc.," he said. "People have had to be creative just to afford and provide health insurance for their employees, so this burden is just being shouldered by not only employers, but working New Yorkers of all stripes.”
Proponents of S. 2530/A. 6194 contend that language added to AMMO after its passage has given health plans room to impose unnecessary additional terms and conditions onto local network pharmacies, essentially excluding them from providing certain medications to patients. By amending the language in AMMO law, advocates of S. 2530/A. 6194 believe it will level the playing field.
But The Business Council maintains that mail order pharmacies have not put local network pharmacies at risk and that there is enough pharmaceutical business for both systems to flourish.
“Like any bill, I think there are definitely groups that have a financial interest in it that are pushing it," Ginsburg said. "I would also suspect there are other groups, perhaps specific special interest patient advocacy groups. And what tends to happen when you sort of peek behind the curtains is that people go out and hunt for allies."
Convincing the public that a slight modification to the AMMO will be beneficial is easy to do, Ginsburg said, but there needs to be a closer look into the drivers of the system.
The Business Council represents the interests of large and small firms throughout the state of New York, and is comprised of thousands of member companies, local chambers of commerce, and professional and trade associations.
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