OTC medications are typically not covered making them unaffordable and less accessible to the majority of the population.
A Republican proposal to repeal and replace the Affordable Care Act has been made called the American Health Care Act (AHCA), also being referred to as "Trump Care." This replacement is still in motion as it still needs approval from the Senate and President to become a law, however it is important to be aware of what the act is and to have an idea on the impacts it can have on health care as it appears it may have a significant effect in the future on over-the-counter (OTC) medications.
Research shows that 81% of adults use OTC medicines as a first response to minor ailments. As pharmacists, we tend to recommend OTC medications to our patients on a daily basis. Unfortunately, OTC medications are typically not covered, making them unaffordable and less accessible to the majority of the population. This tends to direct underserved populations to depend heavily on higher cost medical care for even the smallest ailments. The AHCA can potentially solve this problem making OTC medications more accessible and affordable to the public.
What is the AHCA?
The American Health Care Act was passed by the House of Representatives on May 4, 2017 as a measure to replace the Affordable Care Act. AHCA aims to decrease and modify premium tax credits by 2020, establish a patient and state stability fund, restructure Medicaid funding, and repeal many of the taxes that were put in place by the Affordable Care Act. This act will prohibit any federal funding for Planned Parenthood clinics preventing premium tax credits from being applied to any insurance plans that provide coverage for abortions. Above is just a summary of some of the main goals of this act but the one I will focus on in this article is the impact that the act will have on OTC medications, as they play a significant role in pharmacy and overall self-care.
Over the Counter ("OTC") Reimbursements Return
OTC coverage was first lost back in 2011 when the Affordable Care Act was passed making it difficult for many individuals to obtain self-care treatments. The Affordable Care Act’s prohibition on health flexible spending accounts (FSA), health savings accounts (HSAs), and health reimbursement arrangements (HRAs) would be repealed by the AHCA, making OTC medications more affordable to patients.
Currently, FSAs have a $2,600 limit that would be removed once the act became effective. AHCA also intends to double the annual HSA contribution limits above the current contribution limits and overall allowing spouses ages 55 and older to make catch-up contributions to the same HSA.
The Consumer Healthcare Products Association (CHPA) has been working hard in favor of this act to express how important OTC medications are as many individuals depend on them to treat common ailments such as allergies, cough and colds, or pain. According to the CHPA, the availability of OTC medicines creates significant value for the US health care system, averaging a total annual savings of $102 billion. This gives you an idea on the impact this act would have on the health care system and the savings of many individuals if it is to become effective. The reimbursement of OTCs through HSA is hoping to be seen in 2018 if the act is to become a law.
1. H.R. 1628- American Health Care Act of 2017. Congress website. https://www.congress.gov/bill/115th-congress/house-bill/1628. Published May 2017. Accessed May 15, 2017.
2. Summary of the American Health Care Act. The Henry J. Kaiser Family Foundation Headquarters website. http://files.kff.org/attachment/Proposals-to-Replace-the-Affordable-Care-Act-Summary-of-the-American-Health-Care-Act Published May 2017. Accessed May 16, 2017.
3. The Value of OTC Medicines to the United States. Booz & Co., Jan 2012
4. Understanding Trust in OTC Medicines:Consumer and Healthcare Provider Perspectives. Nielsen and IMS, Published March 2013. Accessed May 16, 2017.