Aimed Alliance submitted letters to legislators advocating for limits on copay accumulator programs in 10 states: Maryland, New Mexico, Connecticut, Kentucky, New York, Nebraska, South Dakota, Oregon, Ohio, and Tennessee. These programs prevent third party assistance to patients, such as drug manufacturer’s coupons, from counting toward a patient’s deductible and maximum out-of-pocket limit. This can result in significant financial harm to patients, and patients may be forced to ration their medications or abandon treatment altogether. Aimed Alliance advocated for bills that require payers to include any payments made by the insured or on behalf of the insured when calculating the cost-sharing requirement and maximum out-of-pocket limit. These bills are particularly important during the COVID-19 pandemic, due to elevated unemployment levels and an increased reliance on marketplace exchange plans with high out-of-pocket costs.