New York State Policy Advocacy Support

The Challenge

The core challenge centered on protecting chronically ill patients from two harmful, cost-shifting insurance practices:

1. Non-Medical Switching (NMS)

   • Insurance companies and Pharmacy Benefit Managers (PBMs) were changing prescription drug coverage in the middle of a contract year. This practice disrupted continuity of care and increased out-of-pocket expenses by moving medications to higher-cost drug tiers.
     
     

2. Copay Accumulator Programs

   • Insurers were implementing policies that prevented patients from using copay cards or manufacturer coupons to cover their out-of-pocket expenses or meet their deductibles, making lifesaving medications unaffordable.

Our Approach

The campaign relied on a focused legislative strategy and deep stakeholder collaboration:

1. Strategic Coalition Building

   • We identified and engaged a massive network of third-party organizations. For the NMS legislation, 40 distinct advocacy, civil rights, and aging groups came out in strong support. For the copay accumulator campaign, led by the American Cancer Society Cancer Action Network (ACS CAN), 49 groups signed a letter of support to leadership within just two weeks.
     
     

2. Legislative & Grassroots Activation

   • We integrated the NMS bill into 11 different lobby days and held targeted press conferences with key organization speakers and bill sponsors. The campaign also utilized action alerts, patient "story banking," and letters of support to facilitate direct dialogue with lawmakers.
     
     

3. Comprehensive Media Support

   • We executed a robust media campaign that included extensive traditional news coverage, strategic op-ed placements, and active social media education, including the deployment of educational videos.

The Outcome

The sustained, multi-year advocacy efforts achieved significant legislative and community milestones:

1. Legislative Passage

   • The campaign achieved its primary goal when the NMS legislation successfully passed in both the New York State Senate and the Assembly in 2019. The bill gained tremendous momentum, eventually securing 32 co-sponsors in the Senate, which included 16 out of 19 Senate Insurance Members.
     
     

2. Broad Stakeholder Reach

   • The initiative successfully engaged 40 stakeholder organizations, reached 21 NYS legislators, and involved 53 members of executive leadership, including the governor and the bill's sponsors.
     
     

3. Media Impact

   • The campaign successfully elevated the patient voice, securing significant social media traction and traditional media coverage.
     
     

4. Timeline Note on Enactment

   • While the NMS legislation successfully passed both legislative houses in 2019, the Governor ultimately vetoed the bill in December of that year. While the COVID-19 pandemic delayed reintroduction in 2020, the strong foundation built over the 5-year campaign led to renewed efforts and amended legislative language moving into 2021.