Massachusetts Seniors, Lawmakers ‘Pin Hopes’ on New Rx Drug Program, But Enrollment Trends Raise Concerns for Success

Massachusetts lawmakers and health officials hope that the state's new Prescription Advantage program will address a "mounting nee[d]" for affordable prescription drugs, but the Springfield Union-News reports that the "survival" of the plan "depends on whether the program markets successfully to people who may not necessarily save a lot by joining" (Lauerman, Springfield Union-News, 7/23). The program, which took effect in April, provides prescription drug coverage for low-income Massachusetts residents, as well as individuals over age 65 and those under age 65 with certain disabilities. Enrollees pay premiums, deductibles and co-payments based on the their annual income, with monthly premiums raging from $0 to $82 ( Kaiser Daily Health Policy Report, 4/3). According to the state Executive Office of Elder Affairs, which administers the program, 41,400 state residents have enrolled in Prescription Advantage and about 75% of members fall into the program's lowest income bracket -- $15,698 or less -- and pay no premiums or deductibles. Experts warn that Massachusetts must attract higher-income families to Prescription Advantage to ensure the program's survival. The state has budgeted about $2 million for television and radio advertising this year and $1 million in 2002 to promote the programl and consumer education groups have launched campaigns to educate state residents. However, the Union-News reports that Prescription Advantage may "be a difficult sell."

Other Concerns
The Union-News reports that Prescription Advantage must also attract seniors before "their drug costs have gone through the roof," even though such seniors might not think they need to participate in the program. State officials "realize that they may have to penalize older people who wait until their drug needs become dire" before enrolling, and the paper adds that while enrollment is currently open to all, "at some point there will be a price for waiting." For example, those who enroll more than a year after becoming eligible might have to pay a fee, though officials have not yet determined the amount of any such surcharge or how it might be assessed. The Union-News reports that "such hazy details have dogged Prescription Advantage," with enrollees also unsure whether the program will next year receive $110 million, as proposed by Gov. Jane Swift (R), or $86 million, as proposed by the state House. According to the National Conference of State Legislatures, 26 states have enacted prescription drug subsidy, discount, or tax credit programs, but Prescription Advantage represents the "first universally available drug insurance program" for seniors. The Union-News notes that as a result, other states considering similar programs are watching Massachusetts closely (Springfield Union-News, 7/23). For further information on state health policy in Massachusetts, visit State Health Facts Online.