Healthcare in America and Americans’ access to healthcare have faced changes in 2018. There have been Medicaid eligibility changes, laws proposed and promises made to reduce drug costs, as well as public health concerns highlighted such as gun violence. People in the United States continue to count healthcare costs as a major concern.

We at NeedyMeds prefer to remain apolitical, but it is difficult to avoid the partisan nature of the changes in healthcare in America. The effort to undermine the Affordable Care Act (ACA; aka Obamacare) was continued with the expansion of short-term health insurance with lower premiums but high out-of-pocket costs and low benefit coverage, weakened benefit standards, cutting the ACA outreach

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In a previous blog post, we explored “clawback” and how it affects the prices of prescriptions. In short, Pharmacy Benefit Managers (PBMs) negotiate copay prices for insurers that are often higher than the cash price paid by uninsured patients all while instituting a “gag rule” for pharmacists to forbid them from revealing the price discrepancy to patients unless asked directly. A number of states have already passed laws banning clawback and gag rules, though a group of bipartisan U.S. senators have introduced a bill the ban gag clauses for PBM-negotiated contracts nationwide.

A recent study by Journal of the American Medical Association (JAMA) found that 23% of all prescriptions filled through insurance ended up costing more than patients who would pay out-of-pocket. Related to this, a national poll from West Health Institute/NORC at

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