2010 State Legislative Preview: New York

NEW YORK BLEEDING DISORDERS COMMUNITY MAXIMIZING FORWARD MOMENTUM

Despite a Senate Coup, weeks of political gridlock and the normal parlor intrigue which punctuates New York State Politics — Knickerbockers are looking to build on growing momentum out of the 2009 Legislative session in Albany in the New Year. The past year saw legislation enacted which extended dependent coverage for single adults aged 29 year old or younger. These consumers are allowed to remain on mom and dad’s health insurance policies provided that they are single. This represented a major success for community members transitioning towards independence from college and trade schools toward self sufficiency.   

The greatest priority in Albany for 2010 focuses on “tier IV drug pricing.” Tier IV drug pricing is the practice of pricing the most costly treatments and medications in a way that asks consumers to pay more for them because they are costly. Where a typical insurance policy might have a 20% co-pay a tier IV policy might have a 33% co-pay. For families using $200K worth of product in a year that would represent a increase in annual insurance co-payments from $20,000 to $33,000. 

Currently, New York’s Insurance Commissioner has by law the authority to accept or preclude the issuance of policies that permit tier IV pricing. Pending legislation would instruct the insurance commissioner to not allow insurers to issue policy that use a Tier IV pricing structure.