Mississippi one of 30 states that allows copay accumulators

Tim Storey, CEO, National Conference of State Legislatures, left, and Julie Gull Sheffield, Patients Come First - NCSL.org / PatientsComeFirst.com
Tim Storey, CEO, National Conference of State Legislatures, left, and Julie Gull Sheffield, Patients Come First - NCSL.org / PatientsComeFirst.com
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Mississippi is one of thirty states that allows copay accumulators.

That’s according to an analysis of National Conference of State Legislatures data by Magnolia State News.

A copay accumulator is a program used by some health insurers in the United States that does not count copay assistance payments toward a patient’s deductible or out-of-pocket maximum.

Mississippi does not require insurers to count all payments made by patients, even those from patient assistance programs, toward the patient’s out-of-pocket maximum.

Opponents of copay accumulators, such as Bridget Tyrey, executive director of the Gateway Hemophilia Association (GHA) in St. Louis, Mo, say that copay accumulators cause patients to “basically pay twice, first with their copays assistance card, second from the patient.”

While some health insurers say copay accumulator bans would result in higher insurance premiums, a May 2023 analysis by The AIDS Institute found “no evidence that enacting a copay accumulator adjustment ban has a meaningful impact on average premiums.” That analysis looked at 16 states that banned CAAPS between 2019 and 2022.

Julie Gull Sheffield, who works with the group, Patients Come Firs,, said that copay assistance is a “critical resource” to provide patients the “assistance they need to access medications,” but that “often copay accumulators are used to block those discounts from helping patients by not allowing it to count toward a patient’s deductible and out-of-pocket maximums.”


Which states ban copay accumulators?

Source: National Conference of State Legislatures

State Name Ban on Copay Accumulators?
Alabama No
Alaska No
Arizona Yes
Arkansas Yes
California No
Colorado Yes
Connecticut No
Delaware No
District of Columbia Yes
Florida No
Georgia Yes
Hawaii No
Idaho No
Illinois Yes
Indiana No
Iowa No
Kansas No
Kentucky Yes
Louisiana No
Maine Yes
Maryland No
Massachusetts No
Michigan No
Minnesota No
Mississippi No
Missouri No
Montana No
Nebraska No
Nevada No
New Hampshire No
New Jersey No
New Mexico Yes
New York Yes
North Carolina Yes
North Dakota No
Ohio No
Oklahoma Yes
Oregon No
Pennsylvania No
Rhode Island No
South Carolina No
South Dakota No
Tennessee Yes
Texas Yes
Utah No
Vermont Yes
Virginia Yes
Washington Yes
West Virginia Yes
Wisconsin No
Wyoming No


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