State Lawmakers to Tackle High Prescription Drug Costs

Published in the Woonsocket Call on February 16, 2020

The Washington, DC-based AARP began its call for reducing prescription drug prices nationally in the late spring of 2019. At the same time, state legislatures around the country began taking up legislation. However, in Rhode Island, where the legislature meets only once a year, from January to June, it was too late to introduce bill in last year’s session.

AARP’s Elaine Ryan, VP of State Advocacy and Strategy reports: “We’re seeing an unprecedented number of states tackling the problem of high prescription drug prices. About 45 states expect to engage on prescription drug legislation or regulations this year. Right now, AARP is actively engaged in legislation in 25 states to address rising prescription drug prices. A variety of bills are moving through state legislatures, including bills on cost-sharing caps on insulin, price transparency, importation, price gouging, and affordability boards.”

Now, AARP Rhode Island is gearing up its lobbying efforts on Smith Hill this legislative session to put the brakes on rising prescription drug costs.

High Prescription Costs Top AARP Rhode Island’s Issues

State Director Kathleen Connell, of AARP Rhode Island, led the charge against skyrocketing drug costs by taking the group’s “Stop Rx Greed: Cut Drug Prices Now” campaign to four Rhode Island communities. At its AARP RI Community Conversations kickoff event in Warwick on Oct. 15, she called on Congress and the Rhode Island General Assembly to make prescription drugs more affordable a legislative priority. “We pay not only at the pharmacy counter, but through higher insurance premiums, and through the higher taxes we need to pay to fund programs like Medicare and Medicaid. Older Americans are hit especially hard. Medicare Part D enrollees take an average of 4 to 5 prescriptions per month, and their average annual income is around $26,000. One in three Americans has not taken a medication as prescribed because of the cost,” she said.

Connell reported that a recent AARP Rhode Island’s survey revealed that 79 percent of the member respondents called for lowering the price of prescription drugs, considering it the organization’s top priority.

During these events, using state-by-state specific data released last summer by AARP researchers, Connell was able to use Rhode Island data to document an increase in drug costs for seniors, identifying these drugs, the number of Rhode Islanders who need them and how much costs have risen.

Rhode Island’s state specific data revealed that the average annual cost of brand name prescription drug treatment increased 58 percent between 2012 and 2017, while the annual income for Rhode Island increased only 5.6 percent. Prescription drugs don’t work if patients can’t afford them, says the aging advocacy group, says Connell.

AARP Rhode Island also held Community Conversations in North Providence (Oct. 29), East Providence (Nov. 21) and Newport (Dec. 5). About 80 people attended these events, including in the legislative districts in those communities, along with Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) and House Majority Leader Joseph Shekarchi (D-District 23, Warwick).

AARP Rhode Island Calls for Lower Prescription Drug Costs

On Feb. 5, over 120 people, including state lawmakers, Secretary of State Nellie M. Gorbea, and AARP Rhode Island staff and members, gathered in the State Room to attend the AARP Rhode Island Annual Reception. The event would become the backdrop to announce the Rhode Island Senate’s legislative agenda to tackle increasing prescription drug costs, the unveiling of package of eight bills supported by AARP Rhode Island.

At the event, Connell said: “This is an issue we are pounding on and I think you are going to see progress this year on this stellar important issue – Stop Rx Greed. I don’t need to go through the list of hardships suffered as these prices escalate way beyond reason. And we know this can’t continue the way it is. It’s probably not going to be a silver bullet that will solves this, but a lot of lot more work of the kind you have seen to make this iceberg move.”

Senate President Ruggerio along with 14 Senators from his chamber came to announce their support of the AARP sponsored legislation that would provide a pathway to import less-costly drugs from Canada, increase more market transparency, raise senior’s awareness around price changes and limit patients’ share of the costs.

House Majority Leader Shekarchi, came to the legislative reception with 20 House lawmakers, to share their concern about the lack of affordability of prescription. Shekarchi personally knows about high drug costs. “I am a Type II Diabetic and I have a lot of prescriptions. I feel the pain because I pay $30 a pill with the copay. I know what it costs and it is ridiculous,” he says.

“Patients deserve to know what drugs will cost, how they can pay for them in a fair and reasonable way, and how they can take advantage of any or all opportunities to save on those costs,” said Shekarchi, stressing that “people living on fixed incomes should not have to skimp between doing what is essential in buying prescription drugs, or food or housing.”

Shekarchi noted that he has already put in legislation with House colleagues, calling for Rhode Island’s insurers to completely cover the cost of copays for epinephrine injectors, or EpiPens. The bill would help reduce the high cost of the injectors, which has prevented some people with allergies from obtaining the life-saving device. The Warwick lawmaker also cosponsored a bill to create a prescription drug affordability board to protect Rhode Islanders from the high costs of prescription drug products.

Shekarchi concluded, by announcing that House lawmakers will shortly join the Senate in introducing AARP’s package of legislation (from five up to eight bills).

In a statement announcing the introduction of Senate bills to lower prescription drug costs, Ruggerio said: “Rhode Island’s population is one of the oldest in the nation, and the high prices consumers pay for prescriptions have a significant impact on us. Most older Rhode Islanders have limited means, and the high costs mean many people are cutting back on essentials of living or taking less than their prescribed amount of expensive drugs. The pharmaceutical industry is not going to address this on its own, so it’s up to the state and federal governments to take action.”

Tackling the High Cost of Prescription Drugs

After AARP Rhode Island’s Annual Legislative Reception, the following legislative proposals were thrown into the legislative hopper that day and companion measures have now been introduced in the House.

Senate legislative proposals included:

A bill limiting changes to a health plan’s drug formulary — its list of covered drugs — to protect consumers. Sponsored by Sen. Elizabeth A. Crowley (D-District 16, Central Falls, Pawtucket), this legislation (S 2324) would generally limit plans to modifying formularies at renewal time with 60 days’ notice and require that modification be identical among all substantially identical benefit plans.

Legislation (S 2319) sponsored by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick) to cap out-of-pocket expenses for prescription drugs at the federal limits for high-deductible health plans, currently $1,400 for individual plans and $2,800 for family plans.

A bill (S 2317) sponsored by Senate Majority Whip Maryellen Goodwin (D-District 1, Providence) to prohibit cost sharing for patients 45 or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies or plans.

Legislation (S 2322) sponsored by Sen. Melissa A. Murray (D-District 24, Woonsocket, North Smithfield) to limit the copay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin.

A bill sponsored by Sen. Walter S. Felag Jr. (D-District 10, Warren, Bristol, Tiverton) requiring pharmacists to advise patients about less-expensive generic alternatives to their prescriptions or when it would cost them less to pay for their drugs outright instead of using their insurance. The bill (S 2323) would also bar pharmacy benefits managers from imposing gag orders on pharmacists that prevent them from making such disclosures.

A prescription drug transparency act (S 2318), sponsored by Senate President Ruggerio. This bill would requires pharmaceutical drug manufacturers to provide wholesale drug acquisition cost information to the Department of Health and pharmacy benefit managers to provide information related to drug prices, rebates, fees and drug sales to the health insurance commissioner annually. Such transparency would help payers determine whether high prescription costs are justified.

A bill (S 2321) sponsored by Sen. Louis P. DiPalma (D-District 12, Middletown, Little Compton, Tiverton, Newport) to create a state-administered program to import wholesale prescription drugs from Canada, which has drug safety regulations similar to those of the United States. Such programs are allowed under federal law, with approval from the U.S. Food and Drug Administration.

Legislation (S 2320) sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol, East Providence) to create a prescription drug affordability board tasked with investigating and comprehensively evaluating drug prices for Rhode Islanders and possible ways to reduce them to make them more affordable.

As the 2020 Presidential election looms, Congress and state law makers are very aware that lowering skyrocketing prescription drug costs is a top priority for their older constituents. With more than 250 bills passed by the Democrats in the House (some of these bills would lower prescription drug costs) sitting in Senate Majority Leader Mitch McConnell’s “legislative graveyard,” the Rhode Island General Assembly must take the lead to legislatively fix the problem.

Connell anticipates that there might be more than 15 drug bills in the House and Senate, 10 submitted by AARP. Rhode Island lawmakers must seriously consider these legislative proposals and join the 26 states that have already passed new laws aimed at lowering prices for prescription medications.

AARP Says Age Discrimination Robs $850 Billion from Nation’s Economy

Published in the Woonsocket Call on February 9, 2020

In 1985, my 71-year old father was ready to leave his job, looking for greener pastures. After working for Dallas, Texas-based Colbert-Volks for over 33 years as Vice President, General Merchandise Manager, he knew it was time for a job change.

After telling me of his desire to find a new employment, I told my father that he would bring over three decades of experience in the retail sector to a new company along with a vast network he had accumulated. I remember saying “You would be a great catch.” His curt response: “Nobody will hire me at my age.”

Thirty-five years after this conversation, AARP releases a report charging that age discrimination is still running rampant in America’s workplaces and it even negatively impacts the nation’s economy, too.

Last month, AARP and the Economist Intelligence Unit released a report, The Economic Impact of Age Discrimination, reporting that the age 50 and over population contributed 40 percent of the U.S. Gross Domestic Product (GDP) in 2018, creating 88.6 million jobs and generating $5.7 trillion in wages and salaries through jobs held directly or indirectly.

But older workers would have contributed a massive $850 billion more in 2018 to the GDP if they could have remained in or re-entered the labor force, switched jobs or been promoted internally, notes the AARP study.

AARP’s new study shows that the elimination of that bias in 2018 would have increased the contribution of the 50-plus cohort to the GDP from $8.3 trillion to $9.2 trillion. It also projects that the potential contribution of the older population could increase by $3.9 trillion in a no-age bias economy, which would mean a total contribution of $32.1 trillion to GDP in 2050.

“This important report shows the cost to the entire economy of discriminating against older workers,” said Debra Whitman, AARP’s Executive vice president and Chief Public Policy Officer in a Jan. 30, 2020 statement announcing the release of the 22-page report. “The economy in 2018 could have been 4 percent larger if workers did not face barriers to working longer,” says Whitman.

“Studies have shown that older workers are highly engaged, with low turnover, and often serve an important role as mentors,” Whitman added. “Their expertise helps businesses and pays big dividends for the economy as a whole. Employers who embrace age diversity will be at an advantage,” she says.

House Moves to Combat Age Discrimination

The groundbreaking AARP report comes on the heels of the House of Representative’s recent passage of HR 2030, “Protecting Older Workers Against Discrimination Act,” to combat age discrimination.

The House chamber’s action comes as older workers play an increasingly important role in the workforce. Estimates are that by 2024, 41 million people ages 55 and older will be in the labor force, nearly an 8 percent increase from the current number. In addition, next year the oldest millennials will start turning 40 and then will be covered by the Age Discrimination in Employment Act (ADEA).

The legislation, passing with bipartisan vote of 261-155, restores anti-discrimination protections under the ADEA that were weakened by the Supreme Court’s 2009 decision in Gross v. FBL Financial Services, Inc. The decision changed the burden of proof for workers to be the sole motivating factor for the employer’s adverse action, making it much harder for workers to prove age discrimination.

In the Senate, the bipartisan companion legislation (S.485) is sponsored by Senators Chuck Grassley (R-Iowa) and Bob Casey (D-PA).

“The House vote sends a strong bipartisan message that age bias has to be treated as seriously as other forms of workplace discrimination,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer. “Age discrimination is widespread, but it frequently goes unreported and unaddressed,” charges LeMond.

Thoughts on Age Discrimination

AARP’s new report includes survey findings gleaned from a study conducted last July and August, interviewing 5,000 people age 50-plus to identify how they have experienced age discrimination at work or while looking for work.

The researchers analyzed: involuntary retirement due to age bias; 50-plus workers involuntarily in part-time jobs; missed opportunities for wage growth; lost earnings following involuntary job separation; longer periods of unemployment compared to younger workers; and people age 50 and older who dropped out of the labor force, but want to continue working.

The study’s findings indicate that the age 50 and over labor force has grown by 80 percent since 1998, about 40 percent of workers age 65 over intend to continue working into their 70s. While 80 percent of employer’s support employees working into their later years, nearly two-thirds of older workers say they have experienced or seen age discrimination in the workplace.

As to gender, the study’s findings note that men who retire between ages 50 and 64 are most likely to feel that they are being forced into retirement because of their age. Older women bear the double burden of age and gender discriminate, say the researchers. Those age 50-64, especially women, experience longer unemployment than other groups

The study also found that lower-income workers are more likely to feel trapped in their present role as a result of age discrimination.

AARP’s report warns that “in order to benefit from age ‘inclusion,’ employers need not only to recognize age bias, but actually “actively” stop it; they need to “bust myths” about older workers, be it that they cost too much or are not tech-savvy; they need to recognize the value that experienced workers bring to the workplace, like their dependability and ability to problem-solve and remain calm under pressure, and they must build and support a multigenerational workforce.”

Final Thoughts

We have worked for years to raise awareness of valuing people in the workforce, regardless of age,” said AARP Rhode Island State Director Kathleen Connell. “This isn’t AARP rhetoric. Data repeatedly proves that age discrimination is not only is unfair to older workers, but something that also has a negative impact on the economy.

“Employers should take advantage of the best talent available without dismissing equally capable employees at a certain age or by choosing not to hire new workers simply because of their age,” Connell added. “Companies with a diverse cultural often laud that as a business asset. That philosophy should not exclude older workers. They can bring experience and wisdom into the mix and should be judged only on their performance.”

For information on AARP workforce-related resources, go to http://www.aarp.employers.

For a copy of AARP’s report, go to http://www.aarp.org/content/dam/aarp/research/surveys_statistics/econ/2020/impact-of-age-discrimination.doi.10.26419-2Fint.00042.003.pdf.

In re-establishing House Aging Committee, hopefully the third time is indeed the charm

Published in the Woonsocket Call on February 2, 2020

Twenty-six years after the House Democratic Leadership’s belt-tightening efforts to save $1.5 million resulted in the termination of the House Permanent Select Committee on Aging, U.S. Congressman David N. Cicilline reintroduces legislation to reestablish the House Aging panel, active from 1974 until 1993. Initially the House panel had 35 members but would later grow to 65 members.

According to Cicilline, the House can readily authorize the establishment of a temporary ad hoc select committee by just approving a simple resolution that contains language establishing the committee – describing the purpose, defining members and detailing other issues that need to be addressed. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

At press time, for the third time, Cicilline’s resolution (House Resolution 821; introduced Jan. 30, 2020) to re-establish the House Aging Committee has been introduced and referred to the House Committee on Rules for mark up and if passed will be considered by the full House.

The Nuts and Bolts

The House Resolution (just over 245 words) reestablishes a Permanent House Select Committee on Aging, noting that the panel shall not have legislative jurisdiction, but it’s authorized to conduct a continuing comprehensive study and review of the aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care.

Cicilline’s House Resolution would have authorized the House Aging Committee to study the use of all practicable means and methods of encouraging the development of public and private programs and policies which will assist seniors in taking a full part in national life and which will encourage the utilization of the knowledge, skills, special aptitudes, and abilities of seniors to contribute to a better quality of life for all Americans.

Finally, the House Resolution would also allow the House Aging Committee to develop policies that would encourage the coordination of both governmental and private programs designed to deal with problems of aging and to review any recommendations made by the President or by the White House Conference on aging in relation to programs or policies affecting seniors.’

Initial Resolution Blocked by the House GOP

On March 1, 2016, Cicilline had introduced House Resolution 758 during the 114th Congress (2015-2016) to reestablish the House Aging Committee. It attracted Rhode Island Congressman James R. Langevin (D-RI) and 27 other cosigners (no Republicans) out of 435 lawmakers. Seniors Task Force Co-Chairs, U.S. Congress Women Doris Matsui (D-CA) and Jan Schakowsky (D-IL) also signed onto supporting this resolution.

However, it was extremely obvious to Cicilline and the Democratic cosigners that it was important to reestablish the House Aging Committee. Correspondence penned by the Rhode Island Congressman urged House Speaker Paul Ryan (R-WI) and the House Republican leadership to support House Resolution 758. But, ultimately no action was taken because Ryan had blocked the proposal from being considered.

At that time, Cicilline remembers that many of his Democratic House colleagues didn’t think House Resolution 758 would gain much legislative traction with a Republican-controlled House. However, things are different today with Democratic House Speaker Nancy Pelosi (D-California) controlling the legislative agenda in the chamber.

During the 115th Congress (2017-2018), Cicilline continued his efforts to bring the House Select Committee on Aging back to life. On March 01, 2017, he threw House Resolution 160 into the legislative hopper. Twenty-Four Democratic lawmakers became cosponsors and but no Republicans came on board. House Speaker Ryan again derailed the Rhode Island Congressman’s attempts to see his proposal passed.

Third Times the Charm

Since a Republican-controlled Congress successfully blocked Cicilline’s simple resolution from reaching the floor for a vote in 2017, the Democratic lawmaker has reintroduced his resolution in the current Congress with the Democrats controlling the chamber’s legislative agenda.

Cicilline is working to get support from both Democratic and Republican lawmakers and has approached the House leadership for support. He plans to again reach out to aging advocacy groups for support, including the Leadership Council on Aging Organizations, consisting of some 70 national organizations, whose leadership includes the AARP, the National Council on Aging, the Alliance for Retired Americans, and the National Committee to Preserve Social Security and Medicare.

“Our nation’s seniors deserve dedicated attention by lawmakers to consider the legislative priorities that affect them, including Social Security and Medicare, the rising cost of prescription drugs, poverty, housing issues, long-term care, and other important issues,” said Cicilline in a statement announcing the reintroduction of his House resolution to bring back the House Aging Committee. “I’m proud to introduce this legislation today on behalf of seniors in Rhode Island and all across America,” says the Rhode Island Congressman who serves on the House Democratic leadership team as Chairman of the Democratic Policy and Communications Committee.

According to Cicilline, for nearly two decades, the U.S. House Permanent Select Committee on Aging was tasked with “advising Congress and the American people on how to meet the challenge of growing old in America.” The Select Committee did not have legislative authority, but conducted investigations, held hearings, and issued reports to inform Congress on issues related to aging.

“The re-establishment of the Permanent Select Committee will emphasize Congress’s commitment to current and future seniors. It will also help ensure older Americans can live their lives with dignity and economic security,” says Cicilline.

Looking Back in Time

In 1973, the House Permanent Select Committee on Aging was authorized by a vote of 323 to 84. While lacking legislative authority to introduce legislation (although its members often did in their standing committees), the House Aging panel would begin to put the spotlight on specific-aging issues, by broadly examining federal policies and trends. Its review of legislative issues was not limited by narrow jurisdictional boundaries set for the House standing committees.

In 1993, Congressional belt-tightening to match President Clinton’s White House staff cuts and efforts to streamline its operations would seal the fate of the House Aging Committee. House Democratic leadership cut $1.5 million in funding to the House Aging Committee forcing it to close its doors (during the 103rd Congress) because they considered it to be wasteful spending because the chamber already had 12 standing committee with jurisdiction over aging issues.

Even the intense lobbying efforts of a coalition of Washington, DC-based aging advocacy groups including AARP, National Council on Aging, National Council of Senior Citizens, and Older Woman’s League could not save the House Aging Committee. These groups warned that staff of the 12 standing committees did not have time to broadly examine aging issues as the select committee did.

Aging groups rallying in the support of maintaining funding for the House Aging Committee clearly knew its value and impact. In a March 31, 1993 article published in the St. Petersburg Times, reporter Rebecca H. Patterson reported that Staff Director Brian Lutz, of the Committee’s Subcommittee on Retirement Income and Employment, stated that “during its 18 years of existence the House Aging Committee had been responsible for about 1,000 hearings and reports.”

As an advocate for the nation’s seniors, the House panel prodded Congress to act in abolishing forced retirement, investigating nursing home abuses, monitoring breast screening for older woman, improving elderly housing and bringing attention to elder abuse by publishing a number reports, including Elder Abuse: An Examination of a Hidden Problem and Elder Abuse: A National Disgrace, and Elder Abuse: A Decade of Shame and Inaction. The Committee’s work would also lead to increased home care benefits for the aging, and establishing research and care centers for Alzheimer’s Disease.

Aging Advocates Give Thumbs Up

“The Senate has had the wisdom to keep its Special Committee on Aging in business which has meant a laser-like attention on major issues affecting seniors including elder abuse, especially scams and other forms of financial exploitation,” says Bill Benson, former staff director of the Committee’s Subcommittee on Housing and Consumer Interests. The House has been without a similar body now for decades, he notes.

Benson adds, “With ten thousand Americans turning 65 each day we are witnessing the greatest demographic change in human history. It is unconscionable to not have a legislative body in the House of Representatives focused on the implications of the aging of America.”

Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, served as staff director for the Senate Special Committee on Aging from 1987 to 1989. He agrees that it’s time once again for the House to have its own committee dedicated to older Americans’ issues.

With the graying of America it is more important now than ever that seniors’ interests are represented as prominently as possible on Capitol Hill, says Richtman. “There is so much at stake for older Americans today, including the future of Social Security and Medicare, potential cuts to Medicaid, and the myriad federal programs that lower income seniors rely upon for everything from food to home heating assistance. We fully support Rep. Cicilline’s efforts to re-establish the House Permanent Select Committee on Aging,” he states.

“We enter 2020 in the midst of the predicted aging of America including the fact that all boomers are now over age 55, says Robert Blancato, president of Matz, Blancato and Associates, who was the longest serving staff person on the original House Aging Committee, from 1978 to 1993.

“We need the specific focus that only a select committee can offer to the myriad of issues related to aging in America,” adds Blancato, noting that it would be a coveted Committee to be named to from both a policy and political perspective.

Four years after the death of Congressman Claude Pepper, (D-Florida) in 1989, the former Chairman of the House Select Committee on Aging, serving as its chair for six years, would have turned in his grave with the House eliminating his beloved select committee. House Speaker Nancy Pelosi might honor the late Congressman who was the nation’s most visible spokesperson for seniors, by bringing the House Select Committee on Aging back this Congressional session.