Improving patient care should always be the driving force behind any legislation introduced at the state capitol, which is why I introduced Senate Bill 1270, a bill to exempt certain medications from an insurance practice known as step therapy.
Step therapy is a process implemented by insurance companies, pushing patients into less expensive medications before “stepping up” to drugs that can be more effective.
Often times, these less expensive drug treatments are offered as alternatives to a doctor’s prescription. By only approving more expensive levels of medication after the failure of a cheaper alternative, health insurance companies reduce the burden of cost for them.
As a business practice, it makes sense. However, forcing patients to endure this step-based approach can lead to prolonged pain and illness. Doctors, not insurance companies, know what the best course of treatment is for their patients. And since everyone reacts differently to medications, there is no one-size-fits-all treatment for every patient. Fail first, then we’ll cover what will actually help you seems a far cry from patient-centered care.
The inconsistency of step therapy across insurance companies is often a headache for the physicians who have to navigate the appeals process to advocate for their patients. Physicians have gone from diagnosing a problem to fighting insurance companies for the basic health care for their patients.
Right now, the bipartisan-supported SB1270 is making its way through the Arizona House after being approved by the Arizona Senate. SB1270 works to provide transparency, medical justification, and a clear timeline for appeals processes to give physicians the ability to advocate for their patients on an even playing field with the insurance companies.
This bill would standardize the step therapy process across all insurers in the Arizona market to prevent the current bad actor practice many insurance companies are using to cut corners and cut costs at the expense of the patient’s overall health. Thirty-two states have passed similar reforms with none of them seeing insurance rate increases for patients.
Earlier this year, Sen. Murkowski, R-Arkansas, introduced the Safe Step Act to address this very practice at the federal level. Her bill has received over a dozen cosponsors from both sides of the aisle.
The bill is targeted at group health plans and establishes a clear process for exemptions from step therapy and sets a transparent timeline for exemption requests to be processed by insurers.
Good public policy that gives patients more control over their medical options is just one more step in innovating our health care industry. Enacting SB1270 and the Safe Step Act would continue the momentum already built.
Republican Nancy Barto represents District 15 in the Arizona House of Representatives.