EAU CLAIRE, Wis. (WKBT)- Imagine facing a life-threatening diagnosis only to be told by your insurance company that you can’t get the medicine you need when you need it.
It’s a practice known as white-bagging and it’s happening to people all over the state.
And now, a proposed law named after an Eau Claire woman is hoping to put an end to it.
Koreen Holmes of Eau Claire is a wife, mom, and a fighter. In January at 35 weeks pregnant, she found out she had stage 3-C triple negative breast cancer.
“I think it was the very last thing that we would’ve ever expected that I would have breast cancer, especially being pregnant.”
At just 32-years young, Koreen was forced into the battle of her life. Her family, her soldiers by her side.
“We were like in our 3rd term of pregnancy, getting prepared to deliver a baby soon, a month away and then all of the sudden, fast track that because we’ve got 3 days to deliver this child of ours,” said Koreen’s husband Nathan.
Koreen ended up delivering a healthy baby boy. Less than a week later, she started chemotherapy treatments.
“I think of myself as a very optimistic, happy person and I put all of my faith in God and he’s getting me through this,” said Koreen.
But as if fighting one of the most aggressive forms of breast cancer wasn’t enough, Koreen had another fight on her hands.
“It’s unfair, honestly. It’s really unfair. As a cancer patient, this should be the last thing I have to deal with.”
Her insurance company told her care team in the middle of her treatment, they were no longer going to pay for the medication provided by her hospital.
“It came as a total surprise.”
Instead, the medicine would have to come from a specialty pharmacy chosen by the insurance company. It’s a practice known as white bagging.
“It came out of the blue, it was put on us in the middle of the year. I was already going through treatment.”
Nathan said, “All of the sudden to be told we’re not going to be able to do the next treatment, the anxiety and the emotions that set in. I got to feel that from her so that made me realize how important it was that this gets fixed.”
The Wisconsin Hospital Association is seeing white bagging happening more and more across the state over the last 8-12 months.
“We’ve heard cases where patients’ treatment has been delayed so many times because of this that they’ve decided to stop treatment altogether because they feel like it’s too much for them,” said WHA Senior Vice President of Public Policy Joanne Alig.
According to a recent nationwide survey by Vizient, 83% of hospitals said that specialty medicines delivered to them through white bagging did not arrive on time. Another 66% of hospitals reported receiving the wrong dose.
“The drug comes for a specific patient so now all of the sudden you have all these different drugs coming, you have to find storage for them and often they don’t arrive on time,” said Alig.
Republican State Representative Tony Kurtz of Wonewoc is a co-author of Koreen’s law.
“It’s the efforts of the insurance companies to save money because let’s be honest, these drugs are a tremendous amount of money. What bothers me about it and why I got involved, the patient at the end of the day is suffering,” said Rep. Kurtz.
And often times when white bagging is used, Kurtz says life-saving medication ends up going to waste.
“The problem is that medicine is based on your condition 5 days ago. So that medicine might arrive, might be ready for you, but you’re not ready for it and guess what, they can’t use that medicine, that medicine literally goes to waste.”
Koreen said, “It just kind of honestly shows that they don’t care, they don’t’ know what we’re going through and they don’t care.”
Koreen never expected to become the face of a proposed new law, but now that she is, she wants do everything in her power to make sure it passes.
“I want to advocate for other people who can’t do it for themselves. Helping people, potentially save their lives, is what matters to me.”
Some hospitals won’t even let the drugs from outside pharmacies into their hospitals.
Koreen was lucky. Her insurance company gave her a 90-day extension and her treatment was ending by then. However, she knows so many others are not as fortunate.
The bill currently has widespread bi-partisan support in the state legislature with more than 80 co-sponsors signed on.
Also, we did contact the Wisconsin Association of Health Plans for comment and did not hear back.
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