New Medicare Drug Benefit Threatens Over 6M Poor Americans with Loss of Medications, Consumer Group Reports

Main Category: Public Health
Article Date: 10 Jan 2005 - 10:00 PDT

email to a friend   printer friendly   opinions  

New York - Many of the 6,400,000 older adults and people with disabilities whose prescription drugs are covered by Medicaid will be without critical medications when their Medicaid drug coverage is terminated in January 2006, unless the federal government adopts stop-gap measures to ensure continuity, a new study prepared by the Medicare Rights Center reports.

While people with both Medicaid and Medicare who do not choose a Medicare drug plan will automatically be assigned to a Medicare drug plan, millions are at risk of not being able to get their medications because they will not know that their coverage has changed or understand the new benefits, the study found.

"Legislation that is supposed to increase older American's access to needed medicine now threatens to strip over six million men and women of their drug coverage," said Robert M. Hayes, president of the Medicare Rights Center, a national consumer service group. "It is a moral imperative that the Administration and Congress act now to ensure that the neediest Americans not be the unintended casualties of the Medicare changes."

In The Medicare Low-Income Drug Subsidy: Strategies to Maximize Participation, the Medicare Rights Center examines pragmatic solutions to mitigate widespread harm to individuals as they change drug coverage from Medicaid to Medicare. The group recommends that the Centers for Medicare and Medicaid Services (CMS) require Medicare drug plans to offer open formularies or to honor Medicaid program formularies and pharmacy network agreements for a period of six months to a year. It also proposes that Medicaid temporarily continue for people whose Medicare drug plans can not be verified at they time they buy their medications. The Medicare Rights Center also notes that more comprehensive solutions will also require legislative changes to prevent widespread suffering for the poorest and frailest persons with Medicare.

"Congress should act to correct widespread problems with the drug benefit. But this report focuses on what the Administration can to do improve a dangerous situation facing the poorest Americans under existing law," Mr. Hayes said.

According to the Medicare Payment Advisory Commission, a Congressionally created expert advisory agency, it takes from six to nine months for employer-sponsored health plan members to make health plan transitions, the report said.

"People with Medicaid and Medicare tend to be poorer, sicker, less educated, have more cognitive impairments, and use more medications than those in employer-sponsored health plans and other people with Medicare," Mr. Hayes said.

To also ensure that another estimated 8.2 million people with incomes below $13,965 (currently for an individual) and limited assets have access to the Medicare low-income drug subsidy, the Medicare Rights Center offers several recommendations in its study.

Mr. Hayes praised the Administration's efforts to ease enrollment procedures in the current Medicare-approved discount card program, and said that even greater flexibility will be needed to avoid a humanitarian "train wreck" next January.

Click here to see report..

The Medicare Rights Center, founded in 1989, is the largest independent source of information and assistance on health care rights and benefits for older and disabled men and women in the United States. For more information about MRC, call 212-204-6219, or visit the MRC web site: http://www.medicarerights.org.

Contact: Deane Beebe
Communications Director
212-204-6219
dbeebe@medicarerights.org
Medicare Rights Center

• Additional
• References
• Citations