While some states ban insurers from using copay accumulator programs, oversight has stalled at the federal level.

For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that costs more than $7,700 a month. Each year, Amgen, which makes the drug, called Enbrel, sent the coupon card worth thousands of dollars, and that counted toward Gruber’s health insurance deductible and out-of-pocket maximum.

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