Advocacy Groups Support Bills Making Pharmaceutical Drugs More Affordable

Published in the Pawtucket Times on April 21, 2003

The Gray Panthers have been around the Ocean State since 1975.

Richard Bidwell, state coordinator of the Rhode Island Gray Panthers, which represents 400 members state-wide, said his group has fought on behalf of seniors and disable persons on many aging and consumer-related issues.

He recalled one legislative victory that enabled seniors and disabled persons to use a special RIPTA bus pass and ride free during off-peak hours. Later the Gray Panthers would successfully expand this use to all times.

As state coordinator, Bidwell has been involved in lobbying the Rhode Island General Assembly on behalf of the state’s growing senior population for more than 14 years. Last year, the Gray Panthers coordinated their efforts with senior advocacy groups to organize the Senior Agenda Consortium.

This year, the Consortium turns its attention to four legislative proposals that will assist seniors in paying for costly pharmaceuticals.

“We’re trying to get them out of committee with favorable votes,” Bidwell told All About Seniors.

The group has locked horns wit Blue Chip in an attempt to lower prescription drug prices for older beneficiaries who have signed up for that health plan.

S 566, introduced by Sen. James Sheehan (D-North Kingston) would require health plans, such as Blue Chip, to pass on their drug discounts to their members. Blule Chip’s highest premium (costing $148 a month) allows senior beneficiaries to purchase up to $ 1,000 worth of brand-name drugs a year, being charged only a $ 25 co-pay for reach prescription.

This premium also allows a person to purchase up to $ 5,000 in generic drugs, with an $ 8 co-pay charged for each prescription.

Bidwell said that with each purchase of a prescription, Blue Chip subtracts the retail price rather than the actual contracted lower price allowed by the insurance company for the purchase.

As a result,” People are being charged too much,” Bidwell said. “The $ 1,000 coverage is disappearing too quickly with the purchase of each prescription drug.

“Our legislation allows Blue Chip to subtract only the contracted actual price of the prescription rather than the much higher retail price.”

“At press time, the Gray Panthers are attempting to find a House sponsor for this legislation.

A related bill, H 5237, sponsored by Rep. Peter Ginaitt (D-Warwick) and S 374, sponsored by Sen. Elizabeth Roberts (D-Cranston), would allow a person eligible to participate in the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE), who also has prescription drug coverage through a health plan, to use RIPAE to pay for an individual prescription drug once they reach a maximum level of coverage for that drug.  Currently access to RIPAE until he or she uses all of the brand and generic allowance by Blue Chip.

Meanwhile, Bidwell noted that the Gray Panthers are also pushing H 5239, sponsored by Sen. Mary Ellen Goodwin (D-Providence), for expanding RIPAE to allow persons ages 55 to  61 on Social Security Disability Insurance to receive RIPAE co-payments at the same level as Ocean State seniors.

Finally, another legislative proposal, H 5478, sponsored by Rep. Fausto Anguilla (D-Bristol-Warren) and S 299, sponsored by Sen. Rhode Perry (D-Providence), would allow Rhode Island residents to buy prescription drug from Canadian pharmacies, where they are routinely cheaper.

Susan Sweet, an elder rights advocate consultant to non-profit groups and a member of the Senior Agenda Consortium, has called for the passage of these bills, which are key to creating a “responsive and less costly” long-term care system.

“Pharmaceutical drugs may be expensive, but they are certainly less expensive than hospitalization, nursing home care, and other medical services required as a result o a senior not having or taking the prescribed medication,” said Sweet.

“It is primarily the advances in pharmaceutical therapy that have enabled seniors to live longer and healthier lives. By permitting more access for seniors and persons with disabilities to afford their prescriptions, state policy makers can save people’s lives and ultimately save taxpayer money by preventing more costly interventions,” added Sweet.

At the AARP gubernatorial debate, seniors called for state government intervention in putting the brakes of rising pharmaceutical costs.

The calls for action continue to grow. During this legislative session, the Gray Panthers, AARP, the RI Commission on Aging, along with the Forum on Aging and the Senior Agenda Consortium, have made this legislative issue a high priority.

It is time for Gov. Don Carcieri and the leadership of the General Assembly to tackle this senior issue head-on and allocate the necessary state funds to help make prescription drugs more affordable for Rhode Island seniors and persons with disabilities.

Because of the growing costs of medication, a large number of seniors cannot afford to fill their prescriptions, many do not event take their prescriptions as directed by their physicians.”  Noncompliance in taking medications or not taking them at all can result in unnecessary hospitalization, premature admission to nursing facilities, and untimely death.

Even with the state’s looming budget deficit, enabling seniors to afford the purchase of needed pharmaceutical drugs will hopefully be placed on the General Assembly’s short list of bills that must be enacted this legislative session.

Call Senate President Bill Irons at 401-222-2447 and House Speaker Bill Murphy at 401- 222-2466 to tell them of your concerns about this issue and how   the high cost of prescription drugs hits you in your pocketbook.

Urge these key lawmakers to pass legislation that makes pharmaceuticals more affordable to all seniors and persons with disabilities

Senior Advocates Push Legislation That Would Save State Money

Published in the Pawtucket Times on April 14, 2003

While the Rhode Island General Assembly is tackling hot-potato political issues like separation of powers and gambling, hundreds of bills have been thrown into the legislation hopper. Senior advocates are tracking about 13 legislative priorities in the 2003 legislative session.

Lawmakers are considering a wide array of legislation -creating long-term care tax credits, expending the Rhode Island Pharmaceutical Assistance to the Elderly Program, strengthening the state’s ombudsman’s office and ratcheting up Medicaid payments to nursing facility providers. One bill would establish special funds to care for severely disabled (age 65 and over) legal immigrant elders who are not eligible for Medicaid.

As they deal with a huge state budget deficit, Gov. Don Carcieri and lawmakers will be wary of enacting legislation that will have a fiscal impact on the state coffers.

But senior advocates are pushing for enactment of several legislative proposals that are either budget neutral or will actually save taxpayer dollars.

One legislative proposal (H 5841/S 876) that would create revisions to the state long-term care ombudsman law to expand the scope and authority for this state’s elderly advocate.

“Previously, the Rhode Island state statute has not reflected federal law, and this bill remedies that oversight,” said Roberta Hawkins, executive director of the Alliance for Better Long-Term Care and  state ombudsman, who noted federal law requires each state’s ombudsman statute to reflect the federal Older American Act.  Currently, Rhode Island’s statute does not.

Hawkins said the proposed statute changes also add additional duties authorized by the federal Older Americans Act to those required of the ombudsman under Rhode Island law. Companion bills introduced in the House and Senate call for the state ombudsman to represent the interest of nursing facility residents or clients of service providers before  government agencies, and to seek administrative, legal and  other remedies to protect their health, safety, welfare and rights.

They also mandate that the state ombudsman review and comment on any existing and proposed laws, regulations and state policies impacting nursing facility residents and clients of service providers.

The legislative proposals would make a new section of the state ombudsman law that fines a person up to $ 1,000 who willfully interferes with the ombudsman duties.

At press time, these bills were approved by the House’s Health Education and Welfare Committee and the Senate’s Health and Human Services Committee for consideration for floor action at a later date.

Meanwhile, Susan Sweet, an elder rights advocate who also consults for nonprofit agencies, noted two legislative proposals would actually save the state money while providing more appropriate services to older Rhode Islanders.

Sweet said these legislative proposals (H 5246/ S 314) would require the Department of Human Resources to reallocate funds to support already federally-approved assisted-living support services. At present, more than 35 people have qualified for this program but still remain in costly nursing facilities (at $ 130 per day) rather than reside in assisted living facilities which cost approximately 50 percent what the state is paying for nursing facility services.

At press time, these legislative proposals are still under consideration in the Senate and House Finance committees.

“If the General Assembly fails to enact funding for federally approved assisted living services, I would hope they would reallocate resources to at least allow those currently on the waiting list – some of whom are already in  nursing facilities costing the state twice as much = to be under the waiver,” said Sweet. “This would save half of the money currently being paid while providing these elders a better quality of life.”

Another legislative proposal (H 5418/ S 506) said Sweet, would establish a fund for severely disabled elderly legal immigrant Rhode Island residents who are not eligible for Medicaid.

Presently, these legal elderly immigrants receive care only from hospital. Sweet said there are currently four or five of these disabled elders residing at Eleanor Slater Hospital at a cost to taxpayers of $ 749 per day per person. If this legislation were enacted, these severely disabled elders could be transferred to a nursing home at the Medicaid rate of less than $100 per day.

At press time, these legislative proposals are still under consideration in the Senate and House finance committees.

Sweet noted the requested allocations for placement in nursing facilities for disabled elders who are legal immigrants is just $ 250,000 a year.

“Considering that we know that care for one persona at Eleanor Slater Hospital costs the state $ 749 per day, more than $ 273,000 annually passage of this bill is a no-brainer,” says Sweet. “In times when money is tight, there is more reason to save money while providing more appropriate services to our elders.”

In the shadow of a huge budget deficit, the Rhode Island General Assembly now has the opportunity the state money. They should seize the day by enacting they legislative proposals.

Bush’s “just guns, no butter” policy hurts senior programs

Published in the Pawtucket Times on March 31, 2003

President Lyndon B. Johnson’s “Guns and Butter” policy is not in fashion today.

In a recent Washington Aging Report, radio commentator Bill Benson predicted future federal funding of program and services for seniors will take a back seat to President Bush’s worldwide fight against tourism, the high-tech war against Iraq and tax breaks for the upper income Americans.

In his Marh 24 commentary, Benson, a former assistant secretary with the U.S. Administration on Aging and now a principal at Health Benefits ABC – sees tough times ahead for the federal funding of programs and services, especially the creation of a meaningful Medicare pharmaceutical assistance program.

“Guns and Butter” was coined nearly 40 years ago, describing President Lyndon B. Johnson’s two-front war. Back then, a large infusion of federal dollars allowed the Democratic president to fight a war abroad – in Vietnam – along with a war on the domestic front, against poverty and social ills, especially those facing the elderly.

“By the end of 1965, with Vietnam escalating, we had the Medicare program and the Older Americans Act,” noted Benson, adding Medicaid was also created at this time to help millions of low-income older people afford the cost of nursing home care.

Benson’s radio commentary charged the Bush administration and the Republican-controlled Congress are fully committed to funding the “guns” but not “butter” policy initiatives.

“It would be one thing if the commitment to guns over butter was for the president while we topple Saddam and occupy Iraq, and combat terrorism everywhere. “Instead, it looks like the Bush administration is committed to making butter a scarcer commodity for years to come,” said Benson.

According to Benson’s proposed budget for the next fiscal year suggests it won’t be both “guns and butter,” especially in light of the president’s efforts to pursue large tax cuts for upper-income Americans.

What about the spending for guns?

According to the Washington Post, Bush’s proposal for the fiscal year begins on Oct. 1, calls for defense spending that is 16 percent more than the combined total of all other discretionary spending excluding what he would spend on homeland security.

And that figure does not take into account the cost of the war in Iraq, nor expenditures to combat terrorism, Benson says.

Meanwhile, Benson said the Washington Post noted secretary of defense Donald Rumford has proposed a $20 billion increase for defense for each of the next six years, would follow what have been six straight years of real increases in defense spending. The result by 2010 would be annual spending for defense of more than half a trillion dollars.

Combine increased defense with the cost of the Iraq war.

Benson noted the White House estimated the cost for Iraq and related matters will be nearly $75 billion over the next six months.

Benson said that by 2011, the first baby boomer s will turn age 65, and will begin placing huge demands up on Medicare, Social Security and other services for the elderly.

“President Bush’s FY 2004 budget calls for $ 400 billion spread over 10 years for a prescription drug plan for senior,” said Benson.

On the other hand, the Congressional Budget Office estimates Medicare beneficiaries will in fact spend more than $1.8 trillion over the same 10 years for prescription drugs.

That means, said Benson, the president’s plan would cover only a bit more than 20 percent of wat seniors will actually spend. And that is if the $ 400 billion actually goes for drug coverage when there will be many other demands for additional Medicare dollars.

Bush also purposes to cut funding for the Older Americans Act – a federal program that supports such services as Meals on Wheels, transportation for the elderly and ombudsmen to investigate problems in nursing homes -by $24 billion, Benson said.

With a worldwide war on  terrorism combined with the ongoing war in Iraq, the debate regarding “guns and butter” spending must begin in earnest.

Hard choices must be made in times of war, but seniors must continue to press both the Bush administration and Congress for adequate federal funding to create a meaningful Medicare pharmaceutical assistance program, and to shore up the ailing Medicare, Medicaid and Social Security programs.

In this new era of huge defense spending, the Bush administration and Congress will have to make very painful choices in allocating its limited discretionary funds to support a wide variety of domestic policy initiatives.

Only an intense lobby of aging advocates and seniors will keep programs and services benefiting the nation’s elderly on the radar screens of federal officials and lawmakers.