Issue Background

Why Do We Need A Federal Oral Parity Law?

FACT: There remains a need for federal legislation despite state passage of chemotherapy parity laws.

- State legislation only impacts individual health plans, small group plans that are not self-insured (regulated by ERISA), and state employee plans. Only federal legislations such as the Cancer Drug Coverage Parity Act can cover cancer patients participating in large-group and ERISA-regulated plans.

- Since state laws vary in their language, their coverage represents a patchwork approach that sometimes leaves out even more plans. For example, the Virginia law does not apply to individual conversion plans from COBRA. The Louisiana and Texas laws specifically exempt plans that cover essential health benefits and are offered on the state health insurance marketplace from the parity requirement. In Iowa, the bill applies to Medicare supplemental plans, while in ever other state it does not.

- While 34 states and the District of Columbia have passed chemotherapy parity legislation since 2007, at the current rate of passage, it would take several years for the remaining states to pass legislation.

- The Cancer Drug Coverage Parity Act will apply to all private health insurance plans, regardless of plan type or location.