Kaiser Daily Health Policy Report Examines Latest State Action on Prescription Drug Prices

The following summarizes recent developments regarding prescription drug coverage in four states:

• Missouri: SenioRx, a state program that provides low-income seniors with financial assistance in purchasing prescription drugs, will have a projected first-year enrollment of 25,000 participants, fewer than half of what officials anticipated. State officials say a lack of publicity, confusion with separate drug company discount plans and a reluctance to enroll in a new program caused the "low turnout." Originally, the state planned to spend $4 million to promote the program, but that amount was reduce to $250,000 because of financial constraints. Rebecca Mankin, the program's executive director, said many seniors did not want to "go through the hassle" of completing the program's three-page application (Wagar, Kansas City Star, 6/24). To qualify for the program, individuals must have annual incomes no higher than $17,000 and couples must earn no more than $23,000 annually. Medicaid beneficiaries are not eligible for the program. The program covers 60% of seniors' generic drug costs; seniors are responsible for the remaining cost, a $25-$35 enrollment fee and deductibles ranging from $250 to $500, based on income (Kaiser Daily Health Policy Report, 3/28).
• Ohio: The Golden Buckeye Card, a prescription discount program for seniors and the disabled, will not begin operation until next year. Although the state Legislature recently approved the program, Ronald Hornbostel, chief of planning, development and evaluation for the state Department of Aging, said the department must develop and approve rules and select a pharmacy benefits manager before the program can begin. An estimated 500,000 people are expected to benefit from the program. The AP/Cincinnati Enquirer provides no details about the amount of the discounts (AP/Cincinnati Enquirer, 6/24).
• Rhode Island: Lt. Gov. Charles Fogarty (D) and Attorney General Sheldon Whitehouse (D) are advocating an expansion of Medicaid prescription drug coverage to beneficiaries of Social Security Disability Insurance. To qualify for coverage under the plan, called "Rx Rhode Island," participants could have annual incomes no higher than 200% of the federal poverty level, or $17,720 for an individual. The proposal is an expansion of the state's pending Medicaid waiver application that would provide Medicaid benefits to certain disabled people under age 65. Between 8,000 and 10,000 people would qualify for the prescription drug benefits under Fogarty and Whitehouse's plan, which would cost the state about $4 million to phase in. Fogarty is seeking reelection and Whitehouse is running for governor (Providence Journal, 6/20).
• Virginia: The state Board of Pharmacy is drafting regulations to comply with a law that will allow some unused medications from nursing homes to be redistributed at free clinics. Under current law, unused pharmaceuticals must be destroyed. The new law, which takes effect July 1, will allow pharmacists to have to determine whether a drug can be dispensed again. The law prohibits prescriptions from Medicaid or the Family Access to Medical Insurance Security program, the state's CHIP program, from being reused (Smith, Richmond Times-Dispatch, 6/24).
• West Virginia: In response to "skyrocketing" prescription drug costs, the state's CHIP program will implement a three-tiered copayment system for medications effective July 1. Beneficiaries will pay nothing for generic drugs, $10 for preferred brand-name drugs and $15 for brand-name drugs not on the state's formulary. Currently, beneficiaries pay $5 for generic drugs and $10 for brand-name drugs (Massingale, Associated Press, 6/19). The change is expected to save the program about $875,000 each year (AP/USA Today, 6/20).