Ohio Bill Aims to Count Copay Assistance Toward Deductibles | SB 207

Ohio Bill Aims to Count Copay Assistance Toward Patient Deductibles

Columbus, OH – A bill currently before the Ohio legislature seeks to ensure that financial assistance patients receive for prescription drugs counts toward their annual deductibles and out-of-pocket maximums. Senate Bill 207, introduced in May 2025 by Senators Susan Manchester (R-Waynesfield) and Beth Liston (D-Dublin), aims to address a practice known as “copay accumulator” programs.

These programs, increasingly implemented by insurers and pharmacy benefit managers (PBMs), often do not count copay assistance provided by drug manufacturers toward a patient’s cost-sharing obligations. While patients can initially use this assistance to afford their medications, they can face substantial, unexpected costs later in the year when the assistance runs out, effectively requiring them to pay twice.

Julie Turner, a Hodgkin lymphoma survivor, traveled to Columbus earlier this month to advocate for the bill’s passage. She shared her personal experience with manufacturer assistance and the challenges she faced when it didn’t count toward her out-of-pocket maximum. “I did my due diligence and contacted a manufacturer,” Turner said. “They actually sent me a debit card that I could use for $6,000 per injection that I need twice a year. But when I got to the end of the year, I realized that was not counted in my out-of-pocket maximum, so for me, it was virtually useless.”

Turner’s story highlights a growing concern about the affordability of prescription drugs, even for those with insurance. She emphasized the importance of ensuring access to life-saving treatments. “We’re allowing the cost of drugs and the cost of medications to be prohibitive for a lot of people, and that’s very sad,” Turner stated. “I want everyone to have the same opportunities for life after cancer, as I’ve had.”

The issue isn’t new to Ohio. Similar legislation failed to pass the Senate in late 2022. However, advocates are optimistic that this latest attempt will succeed, particularly as more states address the issue. According to the HIV+Hepatitis Policy Institute, more than half of states in the U.S. Have already banned copay accumulator programs.

The American Cancer Society Cancer Action Network of Ohio (ACS CAN) is actively lobbying for the bill’s passage, hoping to see it reach Governor Mike DeWine by the end of the year. The HIV+Hepatitis Policy Institute also voiced strong support for SB 207, stating that it ensures health insurers accept and count payments made on behalf of patients toward their deductibles and out-of-pocket maximums.

Opponents of the bill, however, argue that it could disrupt efforts to control prescription drug spending. According to a one-pager from the Ohio Association of Health Plans, SB 207 could undermine a key tool for maintaining affordability for all Ohioans by requiring all third-party payments to count toward cost-sharing limits.

The debate over SB 207 reflects a broader national conversation about drug pricing and access to healthcare. As the bill moves through the legislative process, its outcome could have significant implications for patients across Ohio.