Open Enrollment: Close the Gap?

Woman holding child on lap sitting next to a woman wearing a doctor's coat and stethoscope. Child is giving a high five to the doctor.
By Shane Power, President of Watertree Health… 

Open enrollment is starting again next month, but the time period has changed dramatically: it now only runs from November 1st – December 15th, compared to January 31st in previous years. What probably won’t change is the gap between adequate health insurance and affordability.

As the new plan year starts, it appears likely that huge numbers of individuals and families will remain “underinsured” because they’ll buy the least expensive plan on the marketplace. This means they’ll have high copays, high deductibles, high number of medications not covered and/or high out-of-pocket costs.

This should concern us because price has been cited as the key reason for prescription noncompliance:

  • 20-30% of prescriptions are never filled
  • Approximately 50% of medications for chronic diseases are not taken as prescribed

This lack of adherence causes approximately 125,000 deaths a year and costs the U.S. health care system $100-289 billion annually.

So, what do we do?

A recent article in The Hill by Gary Shapiro, “10 no-brainer ways to cut healthcare costs without hurting quality”, had a few interesting ideas. Below are some that I think should be considered:

  • Let the #1 purchaser of drugs in the U.S.—the federal government—negotiate drug prices
  • Don’t incentivize health care professionals to prescribe more costly drugs
  • When patents expire, get rid of roadblocks to the introduction of generics
  • Think about a price cap on prescriptions

We need to take a fresh approach to the accessibility of health care in America. Otherwise, the cycle of health for millions of Americans will not get better, probably only worse.


Watertree Health is the leading provider of free prescription discount cards benefitting nonprofits year-round. Cardholders save up to 80% off brand name and generic prescriptions at virtually every pharmacy nationwide.

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