Health insurers using drug coverage to discriminate

http://www.eurekalert.org/pub_releases/2015-01/hsop-hi012615.php

Public Release: 28-Jan-2015
Harvard School of Public Health

Some insurers offering health plans through the new federal marketplace may be using drug coverage decisions to discourage people with HIV from selecting their plans, according to a new study from Harvard T.H. Chan School of Public Health. The researchers found that these insurers are placing all HIV drugs in the highest cost-sharing category in their formularies (lists of the plans' covered drugs and costs), which ends up costing people with HIV several thousands more dollars per year than those enrolled in other plans.

The study appears online January 28, 2015 in the New England Journal of Medicine.

"Eliminating discrimination on the basis of preexisting conditions is one of the central features of the Affordable Care Act (ACA)," said Doug Jacobs, MD/MPH candidate at the Harvard T.H. Chan School of Public Health and lead author of the study. "However, the use of formularies to increase costs and dissuade those with preexisting conditions such as HIV from enrolling in the plan threatens to at least partially undermine this goal of the ACA."

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