If you rely on a manufacturer coupon card to help pay for an expensive specialty medication, your insurance plan may be taking that money and not counting it toward your deductible, forcing you to pay out of pocket as if the coupon never existed.
That is the finding of a new investigation by KFF Health News published July 7, 2026. The investigation found that for 2026, nearly 40% of ACA marketplace plans use what the insurance industry calls "copay accumulator programs" — arrangements that intercept drug manufacturer coupon cards, collect the funds, and refuse to count them toward the patient's annual deductible or out-of-pocket maximum.
