RI Senate Tackles High Cost of Prescription Drugs – Herb Weiss

Published in RINewsToday.com on March 15, 2021

In the shadow of the COVID-19 pandemic, as Governor Dan McKee and the Rhode Island General Assembly move to hammer out their Fiscal Year 2022 budget, Senate lawmakers push a package of eight legislative proposals to put the brakes on skyrocketing cost of prescription drugs.

The Senate resolution (2021-S 0560) sponsored by Senate Majority Whip Maryellen Goodwin (D-District 1, Providence), has already been passed and complements the prescription drug affordability package that will be considered next week that would require health insurers to provide coverage, without cost sharing, for colorectal screenings and follow-up colonoscopies when necessary.

The package of legislation aims to protect Rhode Islanders by limiting copays for insulin, capping out-of-pocket expenses for high deductible plans, requiring health insurers to cover preventive colorectal cancer screening, eliminating clauses hidden in pharmacy contracts that prevent a pharmacist from talking about more affordable options, requiring transparent pricing information, importing wholesale prescription drugs from Canada, and creating a board responsible for evaluating and ensuring drug prices are affordable. 

According to Greg Paré, the state Senate director of communications, this package of legislative proposals was developed in conjunction with AARP during the off session before the 2020 Senate session and first submitted last year, but legislation considered last session was limited due to the pandemic and so it did not pass. The legislation has been resubmitted this year with some small modifications and remains a Senate priority.

Last year, AARP along with 14 groups including, the Alzheimer’s Association, the American Cancer Society Action Network, and Aging in Community, urged lawmakers to pass the package of legislative proposals.  Expect to see some of these groups again call for passage of either the total package or specific bills at a Senate Health and Human Services Committee’s virtual hearing, chaired by Sen. Joshua Miller, on Thursday, at 5:00 p.m. For the hearing’s agenda, go to: For hearing details go to: https://bit.ly/3ezofmJ.

Passage of this legislative package would require action by both the Senate and House. At press time, not all of the Senate bills have companion measures in the House.   

Controlling the Skyrocketing Increase of Prescription Drugs

Here are specifics about the Senate’s prescription drug affordability legislative package that will be considered next week by the Rhode Island’s Senate Health and Human Services Committee:  

Legislation (2021-S-0170 sponsored by Sen. Melissa A. Murray (D–Dist. 24, Woonsocket, North Smithfield), would limit the copay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin. Additionally, the bill mandates that coverage for prescription insulin would not be subject to a deductible.  

Legislation (2021-S 0381)sponsored by Senate Majority Leader Michael J. McCaffrey (D–Dist. 29, Warwick), would cap out-of-pocket expenses for prescription drugs at the federal minimum dollar amount for high-deductible health plans, currently $1,400 for individual plans and $2,800 for family plans.    

The bill (2021-S-0383), sponsored by Senator Goodwin (D–Dist. 1, Providence), would save lives by requiring health insurers cover preventive colorectal cancer screening in accordance with American Cancer Society (ACA) guidelines. This coverage must be provided without cost-sharing and includes an initial screening and follow-up colonoscopy if screening results are abnormal. The ACA recommends people at average risk of colorectal cancer start regular screening at age 45.  

A bill (2021-S -497) sponsored by Sen. Walter S. Felag Jr. (D–Dist. 10, Warren, Bristol, Tiverton) would allow consumers to pay less for their prescription drugs by banning gag clauses sometimes found in pharmacy contracts that prevent a pharmacist from talking to a customer about more affordable options.   

This bill (2021-S-0494) would require pharmaceutical drug manufacturers, pharmacy benefit managers, health insurers, and hospitals to disclose certain drug pricing information. Such transparency would help payers determine whether high prescription costs are justified. This bill is sponsored by Senate President Dominick J. Ruggerio (D – Dist. 4, North Providence, Providence).  

This bill (2021-S-0499), sponsored by Sen. Louis P. DiPalma (D–Dist. 12, Middletown, Little Compton, Newport, Tiverton), would 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 rules, with approval from the U.S. Department of Health and Human Services. 

This legislation (2021-S0498) would 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. The bill is sponsored by Sen. Cynthia A. Coyne (D–Dist. 32, Barrington, Bristol, East Providence). 

The bill (2021-S 0496) introduced by Sen. Felag (D-District 12, Bristol, Tiverton, Warren) aims to protect consumers from unexpected changes in their health plan’s formularies (list of covered drugs). Under the legislation, formulary changes can only be made at the time of health plan renewal, if the formulary change is made uniformly across all identical or substantially identical health plans, and if written notice is provided 60 days or more before the change. 

Seniors Hit Hard by High Price of Prescriptions

“The high price of prescriptions is having a severe impact on Rhode Islanders, particularly older residents,” said Ruggerio, noting the state’s population is one of the oldest in the nation.  “Many older Rhode Islanders have limited means, and the high cost of prescriptions means people are 

Ruggerio warns that 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.”

Maureen Maigret, Co-Chair, Long Term Care Coordinating Council, observes that with Medicare paying the tab for costly pharmaceuticals, controlling rising drug costs is a federal issue.  “But this is a big issue to address for those with low and moderate incomes under-insured for prescription drugs,” she says. “I applaud the Senate legislative package aimed at controlling the cost of prescription drugs for Rhode Islanders, says Maigret, who cites the findings of a Kaiser Family Foundation survey that shows one out of four persons take four or more prescription drugs and more than one-third say that have difficulty taking their medication properly due to cost.  “Seniors may fail to get prescriptions filled, resort to pill splitting or skipping doses. Some may end up with costly hospital Emergency Rooms or inpatient visits as health conditions worsen due to the inability to afford their medications, notes Maigret, calling for lawmakers to make necessary prescription drugs affordable for all who need them. Maigret says, “It is time to make necessary prescription drugs available for all who need them.”

“AARP Rhode Island is eager to work with both the Senate and the House of Representatives to pass this important legislation designed to lower prescription drug costs,” said AARP State Director Kathleen Connell. “The high cost of drugs leads families – and particularly older Rhode Islanders on fixed and limited incomes — to often make impossible decisions. No one should have to choose between paying rent, providing food for themselves or their family and vital prescription medications that keep them healthy,” she says.

We look forward to working with legislators from across the state to help improve the health and financial stability of everyone by lowering the cost of prescription drugs. We thank Senate President Ruggerio for once again bringing forth this very important legislation,” adds Connell.

It’s mid-March. Lawmakers turn their attention now to passing the state budget.  Even if the Senate passes every bill in the prescription drug affordability package, the lower chamber must pass companion measures for these bills.  When passed, Governor Dan McKee must sign the legislation to become law.  Right now, it’s an uphill battle and Rhode Islanders must call on their state lawmakers to get on board to support bills to reduce the high cost of pharmaceuticals.  It’s the right thing to do. 

Things that You Should Know 

This meeting will be streamed live online through Capitol TV:

http://www.rilegislature.gov/CapTV/Pages/default.aspx

Written testimony is encouraged and can be submitted prior to 2:00 PM on Thursday, March 18, 2021, in order for it to be provided to the members of the committee at the hearing and to be included in the meeting records. Finally, if you are interested in providing verbal testimony to the committee at this hearing, please go to the following link and make your request by 4:00 p.m., on Wednesday, March 17, 2021:  https://bit.ly/3bIJAs2

Never forgetting will help us keep the promise of “never again.”

Published in RINewsToday.com on February 1, 2021

During a Pro-Trump rally, as thousands of rioters swarmed the US Capitol on Jan. 6, Robert Keith Packer, sporting an unkempt beard, came wearing a black hoodie sweatshirt emblazoned with the phrase “Camp Auschwitz,” in white letters, the name of the most infamous of the many Nazi concentration camps where 1.1 million people were murdered during World War II.  Under a skull and bones at the bottom of his shirt was the phrase, “Work brings Freedom,” a loose translation of the phrase “Arbeit macht frei” that was inscribed above the main entrance gate at Auschwitz and other concentration camps’ gates. 

Packer’s image, 56, a former welder and pipefitter, was circulated widely on social media and by newspapers, evoking shock and disbelief.

Packer, a resident of Newport News, Virginia, was not the only anti-Semitic rioter that day, according to a report released by the Miller Center for Community Protection and Resilience at Rutgers University-New Brunswick and the Network Contagion Research Institute. The report identified at least half a dozen neo-Nazi or white supremacist groups involved in the failed Capitol Insurrection who had also attended President Trump’s “Save America” rally speech. 

In recent years, anti-Semitic incidents have become more common in the Ocean State.

In 2017, the Providence Journal reported that the New England chapter of the Anti-Defamation League recorded 13 incidents of anti-Semitism in Rhode Island. Nazi swastikas were painted on a Providence building, at Broad Rock Middle School in North Kingstown, and even at a Pawtucket synagogue.

Anti-Semitism is Nothing New

But, anti-Semitism, exhibited at the “Save America” rally, has been in our country since its founding, and in fact, has been around western societies for centuries.  Over three years ago, torch marchers, some wearing Nazi-style helmets, carrying clubs, sticks and round makeshift shields emblazoned with swastikas and other Fascist symbols, and others entered the one-block square in downtown Charlottesville, Virginia, to protect a controversial Confederate monument, chanting “Jews will not replace us” and “Blood and Soil” (a Nazi rallying cry).  

The Anti-Defamation League’s (ADL) 2014 Global Index of Anti-Semitism documented world-wide anti-Semitism. The survey found that more than 1 billion people – nearly one in eight – around the world harbor anti-Semitic attitudes. Carried out by First International Resources and commissioned by the ADL, this landmark survey included 53,100 adults in 102 countries representing 88 percent of the world’s adult population.

Over 30 percent of those surveyed said it was ‘probably true’ that Jews have too much control over financial markets, that Jews think they are better than other people, that Jews are disloyal to their country, and that people hate Jews because of the way that Jews behave. 

Most troubling, the ADL study found a large gap between seniors who know and lived through the horrendous events of World War II, and younger adults who, some 75 years after the Holocaust, are more likely to have heard of or learned that six million Jews were exterminated by the Nazis’ “Final Solution.” Nearly half of those surveyed claim to have never heard of the Holocaust and only a third believe historical accounts are accurate.

Gearing Up to Fight Antisemitism

On Jan. 14, the American Jewish Congress (AJC), a global Jewish advocacy organization, briefed the FBI on the continuing threats of anti-Semitism to the nation. 

“Antisemitism fundamentally is not only a Jewish problem; it is a societal one. It is a reflection on the declining health of our society,” Holly Huffnagle, AJC’s U.S. Director for Combating Antisemitism, told the FBI officials on a video conference briefing. “Education is essential, to clarify what constitutes antisemitism, the various sources of this hatred, and what effective tools are available for law enforcement to fight antisemitism,” she said.

The presentation of AJC’s second annual report on antisemitism in the U.S. took place in the wake of the January 6 assault on Capitol Hill, where anti-Semitic images and threats were openly conveyed by some of the rioters.

AJC’s 2020 report, based on parallel surveys of the American Jewish and general populations, revealed that 88 percent of Jews considered antisemitism a problem today in the U.S., 37 percent had personally been victims of antisemitism over the past five years and 31 percent had taken measures to conceal their Jewishness in public.

In the first-ever survey of the general U.S. population on antisemitism, AJC found a stunning lack of awareness of antisemitism. Nearly half of all Americans said they had either never heard the term “antisemitism” (21 percent) or are familiar with the word but not sure what it means (25 percent).

The AJC experts praised the FBI for its annual Hate Crimes Statistics report, which provides vital data on antisemitism. The latest report found 60.2 percent of religious bias hate crimes targeted Jews in 2019. But the report historically has not provided a full picture of the extent of hate crimes, since reporting by local law enforcement agencies is not mandatory.

To improve the monitoring and reporting of hate crimes, AJC continues to advocate for passage of the Jabara-Heyer National Opposition to Hate, Assaults, and Threats to Equality (NO HATE) Act. This measure will incentivize state and local law enforcement authorities to improve hate crime reporting by making grants available and managed through the Department of Justice.

In addition, AJC is asking the FBI to use the International Holocaust Remembrance Alliance (IHRA) Working Definition of Antisemitism as an educational tool. The definition offers a clear and comprehensive description of antisemitism in its various forms, including hatred and discrimination against Jews, and Holocaust denial. 

FBI officials in the Bureau’s Civil Rights Unit, Intelligence Division, and Community Outreach Program, among others, participated in the AJC briefing.

Keeping the memory alive about the Holocaust is key to fighting antisemitism, says Andy Hollinger, Director of Communications, for the United States Holocaust Memorial Museum (USHMM). “”We are seeing a disturbing trend in the rise of antisemitism and the open display of neo-Nazi symbols, most recently at the attack on the U.S. Capitol. This is a long-time problem requiring a long-time solution. We must remember. Education is key. We must learn from this history-learn about the dangers of unchecked hatred and antisemitism. And we must not be silent,” he says.

Adds Bill Benson, who has interviewed Holocaust Survivors before live audiences at the USHMM’s First Person program for more than 2 decades, observes that the majority of those visiting the museum are not Jewish and many of have little familiarity with the Holocaust, and as a result of their visit are profoundly affected by their experience. “The USHMM provides an extraordinary avenue for educating the general public about the Holocaust and anti-Semitism for those millions who visit it, but it is essential that many millions more learn the truth about anti-Semitism and that must done through our educational systems,” he notes.

“The USHMM does an incredible job of educating and assisting teachers who want to teach about the Holocaust, but far too many school systems do not teach about the Holocaust, without which the gulf in knowledge and awareness may only grow as we lose those first-hand knowledge of the Holocaust,” says Benson.

A 2009 report, “Jewish Survivors of the Holocaust Residing in the United States Estimates & Projections: 2010 – 2030,” prepared by the Berman Institute-North American Jewish Data Bank, for the Conference on Jewish Material Claims Against Germany, estimated that 36,800 Holocaust survivors would still be living by 2025. As the number of survivors who witnessed the horrors of Genocide and the Holocaust during World War II continues to dwindle, a growing number of states, including Alabama, Florida, Georgia, Illinois, New Jersey, Ohio, and Texas, and have established Commissions to keep this knowledge alive to millennials, GenZ and  younger generations through educational programming and raise awareness through public education and community events to provide appropriate memorialization of the Holocaust on a regular basis throughout the state.

If the Rhode Island General Assembly legislates the establishment of a Rhode Island Genocide and Holocaust Education Commission, its motto might just be, “Never forgetting” will help us keep the promise of “Never Again.”

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.