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Carter pushing copay legislation after court ruling 

CQ Roll Call

October 11, 2023

Rep. Earl L. "Buddy" Carter is trying to breathe new energy into his bill to protect patients from pharmacy benefit manager tactics to raise costs for patients who rely on copay assistance programs to access their medications. Carter's push comes just after a D.C. Circuit Court ruling prohibiting certain copay accumulators.

His legislation (HR 830), introduced in February, would prohibit the use of copay accumulator tactics that allow health plans and pharmacy benefit managers to pocket a patient's copay assistance by excluding the cost-sharing assistance from counting towards a patient's deductible or out-of-pocket maximum. 

Many drug makers and nonprofits use copay assistance programs to reduce the amount a patient pays at the pharmacy counter, and usually, it counts towards a patient's deductible. But insurers use copay accumulator programs to prevent copay assistance from going towards the deductible by staving off costs in the short-term and then putting them on patients after the assistance runs out.

On Sept. 29, the U.S. District Court for the District of Columbia struck down an HHS rule that allowed insurers to no longer implement such copay accumulator adjuster programs for drugs that lack a generic equivalent. But copay accumulators are still an issue for generics...

Looking ahead: So far, Carter's bill has 94 bipartisan co-sponsors in the House. Carter said he's been assured by the Energy and Commerce Committee staff that the legislation will move this Congress. But some obstacles remain. "First of all, we gotta get our speaker back in and then we gotta go through that appropriations process, that's taking all of the oxygen out of the room right now," he said.

Read the full CQ article here. 

In this week's edition of Buddy's Briefing, we're making it clear that the United States stands with Israel in its fight against Hamas terrorists. 

Monday, October 9, 2023: On Saturday I had the opportunity to attend the 48th annual Odum Day Celebration Parade and Festival in Wayne County. Known as a “Saturday in the South,” this great event included arts and crafts, entertainment, a parade, food, and many other family-filled events.

This morning I stopped by the 9th annual Folds of Honor Golf Tournament held at the Savannah Country Club on Wilmington Island. Folds of Honor is one of the nation’s largest charities providing military families of fallen and disabled veterans with educational scholarships. In Savannah, the organization will provide over half a million dollars for their scholarship program this year including students attending Savannah State University, Savannah Technical Institute, Georgia Southern University, Georgia Southern's Armstrong campus, and Savannah College of Art and Design.

Next, I head to Garden City in West Chatham County where I present a copy of the tribute I made on the House floor to longtime resident and educator Virginia Deloach in honor of her 90th birthday. Joining me at the Deloach presentation are her oldest son, former City of Savannah Mayor Eddie Deloach, and her youngest daughter, Patty, who is also an educator.

Afterwards, I head to downtown Savannah where I speak to the Board of Directors of the Georgia Sheriff’s Association Fall Conference and bring them up to date on public safety legislation in Washington and hear their concerns. The conference includes specialized training and information regarding best practices and procedures.

Next, I head to the Savannah-Hilton Head International Airport for my return trip to Washington. Once back on Capitol Hill, I get situated in my office before heading to a GOP Conference meeting where we discuss the schedule for the next few days and, for nearly three hours, the vacant Speaker’s position.

Tuesday, October 10, 2023: After a series of meetings with staff in my office including with our scheduling, legislative, and communications staff, I have a virtual meeting with our district staff. These breakout meetings are extremely useful in helping us communicate better.

Next, I head to the Longworth Building where I join my Southern Members Coalition colleagues as we meet with the two announced House Speaker candidates, Majority Leader Steve Scalise (R-LA) and Judiciary Committee Chairman Jim Jordan (R-OH) for a question-and-answer session.

Once back in my office, I meet with the political editor of the Atlanta Journal Constitution (AJC), Patricia Murphy, and their Washington correspondent, Tia Mitchell, to discuss the Speaker race and other news of the day.

Next, I have a phone interview with Roll Call to discuss my HELP Copays Act, legislation addressing copay accumulators. Many patients are given discount cards for medications that allow them to get a deduction on their co-payments. However, many insurance companies will not count these discount cards toward a patient’s deductible or out-of-pocket expenses and instead pocket the payment (a process known as copay accumulators). The HELP Copays Act would prohibit this practice by insurance companies.

After heading to the Cannon Rotunda for an on-camera interview with Gray TV (WTOC-TV in Savannah), I head to the Ways and Means Committee room in the Longworth Building for a candidate forum for Speaker where we hear from candidates Steve Scalise (R-LA) and Jim Jordan (R-OH).

Wednesday, October 11, 2023: I’m in the Congressional Visitors Center (CVC) auditorium this morning where I join my congressional colleagues for a classified bipartisan member briefing on Israel where we hear from Acting Deputy Secretary of State, U.S. Department of State, Vicotria Nuland, Acting Undersecretary of Defense for Policy, U.S. Department of Defense, Sasha Baker, and Deputy Director of Mission Integration, Office of the Director of National Intelligence, Morgan Muir.

After the briefing, I head back to the Ways and Means Committee room in the Longworth Building where we have a GOP Conference for nearly three hours to consider amendments to our conference rules before entertaining nominations for Speaker of the House followed by a vote between the two candidates. Finally, after days of tense meetings and passionate speeches, Majority Leader Steve Scalise (R-LA) is elected as our Speaker-Designee.

Once back in my office, I have a virtual interview with WJCL-TV in Savannah to discuss the Speakers race followed by another virtual interview with Fox-28 in Savannah before heading to the Cannon Rotunda where I have an on-camera interview with WTOC-TV in Savannah.

Next, I have an interview with the AJC before heading to the House Recording Studio to record a video for the Georgia Farm Bureau as well as this week’s edition of Buddy’s Briefing.

Friday, October 13, 2023: After a member meeting of the E&C Committee, I head to the Ways & Means Committee room for another GOP Conference where we start the process over in our search for a new Speaker. We begin by considering more amendments to our conference rules before the Speaker Pro-Tem, Patrick McHenry (R-NC), announces that we will pause before having members interested in running for Speaker make their presentations.

After a short break, we’re back in with two candidates running, Jim Jordan (R-OH) and Austin Scott (R-GA). After making presentations and answering questions from the conference, nominations are held and both candidates are nominated. Next, we have an election where Jim Jordan (R-OH) is elected as our Speaker-Designee and promptly asks for unanimous consent to have a count of people who will support him for Speaker on the House Floor. Lacking the requisite number of votes, Speaker-Designee Jordan requests that he be given the weekend to try to garner the necessary votes and Speaker Pro-Tem Patrick McHenry announces that we will adjourn until next week.