New Jersey Senate Approves Prescription Drug Program Expansion

The New Jersey Senate approved 20 health care measures on Dec. 4, including one that would expand the state's prescription drug subsidy program (S. 6) and another (S. 640) that would allow patients denied coverage for services by HMOs access to "a kind of binding arbitration before an independent review board," the New York Times reports. All 20 health care bills still need the approval of the state Assembly and Gov. Christine Whitman (R) before becoming law. Senate President Donald DiFrancesco, who is "a leading Republican contender for governor" in the 2001 election, had proposed expanding the Pharmaceutical Assistance to the Aged and Disabled program. Under the current $310 million program, 190,000 disabled residents and low-income elderly contribute $5 for each prescription. DiFrancesco's proposal, known as Senior Gold, would raise the program's annual income eligibility limits from $19,238 to $29,238 for individuals and from $23,589 to $33,589 for couples. Under the plan, participants would pay higher copayments -- the first $15 of each prescription, then 50% of the rest of the price. The state would be responsible for the other 50%. After an individual had paid $2,000 in a given year, he or she would have to pay no more than $15 for each prescription. While DiFrancesco maintains the program would enroll no more than 100,000 more people during the first year at a cost of $60 million, the nonpartisan Office of Legislative Services estimates that the first-year enrollment could be as high as 142,000 people, costing the state as much as $90 million. DiFrancesco noted that the program's benefits "might have to be cut back if the plan proved much more costly than ... expected." Instead of expansions to the current subsidy, New Jersey Public Interest Research Group lobbyist Jerry Flanagan "urged" state officials to create a state-run "prescription drug co-op." He stated that health officials could "harness" the buying power of New Jersey's 1.2 million elderly residents to negotiate for drug manufacturer discounts.

More Health Measures
The state Senate also approved a measure that expands on a 1997 state law that established the "little-known" Independent Health Care Appeal Program, under which patients can appeal to panels of medical professionals after HMOs have refused or delayed payment. Although the law did not require HMOs to abide by the panels' decisions, the bill approved Dec. 4 would make those decisions binding. Lawmakers also approved a $55 million increase in financial assistance to hospitals that treat uninsured patients (Halbfinger, New York Times, 12/5).