2/9/2018 by Share Your Story

PATIENT STORY SHOWS WHY WE NEED THE CANCER ORAL DRUG COVERAGE PARITY ACT OF 2017

A Milwaukee TV station recently shared the story of a patient that's been "punched in the gut" by her insurance company. We're concerned that her insurance company is potentially breaking the law.


A Milwaukee TV station recently shared the story of a patient that’s been “punched in the gut” by her insurance company.

“The first bill was over $12,000. It was just like another gigantic punch in the gut,” says Jackie Trapp, a patient from Muskego, Wisconsin. That’s despite being over-insured!” According to the TV station:

Trapp said she’s always been over-insured and planned for worst case scenario situations. However, nothing prepared her for the cost of the drug she needs to keep her alive.

We can agree that Jackie’s situation is very troubling — particularly the rest of the story. Her health insurance plan is taking her money and then asking for more by demanding she also cover a large percentage of the cost of her cancer drug. Why? Because her medicine is taken in an oral form, rather than as an IV or injectable cancer therapy.

We can agree that Jackie’s situation is very troubling — particularly the rest of the story. Her health insurance plan is taking her money and then asking for more by demanding she also cover a large percentage of the cost of her cancer drug. Why? Because her medicine is taken in an oral form, rather than as an IV or injectable cancer therapy.

Why isn’t David Mitchell fighting that fight?

Regardless, we are more than up to the task. Jackie and tens of thousands of other patients who are victims of this discrimination don’t need a political press conference — they need direct action and advocates who will tell the truth. Let’s have a productive conversation about HR 1409 the Cancer Oral Drug Coverage Parity Act of 2017 — and begin the persuasive process of reforms that make sense.

This is no time to take partisan sides and manipulate patients for PR goals. The stakes are far too high – and most of all for Jackie.

We’re concerned that her insurance company is potentially breaking the law. If she is really being forced to pay $20,000 out-of-pocket for a medication, then the insurance plan is over-charging her in direct violation of Affordable Care Act limits.

The Affordable Care Act caps cost-sharing at an annual amount that is well below $20,000. For individuals, the cost-sharing cap is approximately $7,000. Even the $14,000 family cap is well below what she’s paying.

Every patient deserves access to the right treatment — not insurance barriers to care.

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TMJ 4 Wisconsin: Muskego Patient Story

Trapp was diagnosed with Multiple Myeloma, a blood plasma cancer, in 2015.

“What happens is, I over produce one type of monoclonal antibody leaving me kind of short on the other three that you’re supposed to have,” Trapp said.

The cancer is terminal but treatable. After the diagnosis, she underwent induction chemotherapy and then Trapp had a bone marrow transplant. After that, she was put on a drug called Revlimid.

“The first bill was over $12,000. It was just like another gigantic punch in the gut,” Trapp.

Trapp said she’s always been over-insured and planned for worst case scenario situations.


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