PhRMA warns out-of-pocket costs could double under O-Care

Tuesday, May 20, 2014
By Paul Martin

By Ferdous Al-Faruque

A new study commissioned by PhRMA finds that many consumers in ObamaCare’s insurance exchanges could end up paying more than twice as much in out-of-pocket drug costs.

The report for the nation’s top drug lobby was conducted by actuarial firm Milliman, which found that people on the Silver Plan, the most popular ObamaCare plan, would likely pay 130 percent more for out-of-pocket prescription drugs compared to people on similar employer-sponsored plans.

One reason why out-of-pocket costs are likely to be higher is because employer plans are more generous than typical Silver Plans, according to the report. However, the numbers don’t account for government subsidies to purchase insurance, which could have a significant impact on overall patient health costs.

“With combined deductible plans, patients are responsible for 100 percent of their non-preventive medical and pharmacy costs before meeting the deductible,” notes the report.

“The findings reveal that the large combined deductibles for all medical spending that are common in Silver plans in Exchanges may disproportionately impact out-of-pocket costs for patients relying on prescription medicines,” it adds.

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