Tag Archives for Robert Greenwood

Congress is Close to Passing Prescription Drug Legislation

Published in Pawtucket Times on June 23, 2003

Within days of the July 4th congressional recess, the House and Senate continue their debates on enacting legislation to lower the cost of pharmaceuticals for the nation’s elderly.

The AARP will kick off a media blitz to get a point across to lawmakers that while they may take a short break during recess, the nation’s elderly don’t get a break when it comes to affording the costly medications they need.

“There’s no recess [for seniors] from high prescription drug costs,”  AARP declares in a press release sent to the nation’s media outlets.

In a written statement, Lt. Gov. Charles J. Fogarty, who chairs the state’s Long-Term Care Coordinating Council, calls on Rhode Island’s congressional delegation to pass meaningful Medicare drug benefits, rather than the legislative proposals being debated in the House and Senate chambers.

“While it is nice that after many years of promises Congress has finally taken on this issue these proposals will cause nothing but heartburn and headaches for seniors if passed,” said Fogarty, noting that many seniors will pay more for the program than they will get back in benefits. He charged that others will even be left without prescription drug coverage when they need it the most.

Under the Senate proposal, seniors would pay a $ 35 monthly premium and then have to meet a $275 deductible before Medicare starts to kick in to pay for half of the drugs costs.  Once senior’s reach a cost cap of $ 4,500 for the last year, they would then have to pick up the entire cost until they reach yet another cap of $ 5,800 in total drug spending. At this point, Medicare would then pay 90 percent of the covered drug costs.

Fogarty noted the Congressional Budget Office found that one-third of seniors would pay more money to enroll in the plan than they would actually get back in benefits.

That’s because a senior with $ 1,000 in annual drug costs would actually end up

$ 1,057 annual for the benefits ($420 in premiums, a $ 275 deductible and half of the drug costs).  A senior with $ 2,000 in drug costs would pay $ 1,557 out-of-pocket for the benefits.

Fogarty also called attention to the major gap in coverage for those whose costs exceed the $ 4,500 limit until they reach that $ 5,800 mark.

Furthermore, Fogarty, who authored the state’s expanded prescription drug program, said a study by Columbia University found that only those annual drug costs about $ 1,100 would benefit through the plan.  

In the House chamber, the Republican proposal also calls for monthly premiums of $ 35 along with a lower annual deductible of $ 250 with Medicaid paying 80 percent of the cost of drugs up to $ 2,000.

There is a gaping hole in coverage (in this legislative package).” Fogarty warned “Seniors would then have to spend at least another $ 1,500 depending on their income, on medications before coverage would again begin.”

According to Fogarty, Consumer Union, the publisher of the widely-read magazine, Consumer Reports, noted the “skimpy benefits [in the House and Senate proposal] and the historically high growth of prescription drug costs means that most who lack coverage today would wind up paying more for prescription drugs in four years than they do now.”

Will seniors see a prescription drug proposal enacted this year?

Probably, said Jason Ormsby, director of policy at the Washington, D.C.-based Allilance for Health Reform.

“There is a tremendous drive that I have not seen in the last there years [to enact a prescription drug bill],” said Ormsby.

He noted the House passed a legislative proposal to assist seniors in paying for costly pharmaceuticals, but it died in the Senate.

“The somewhat similar House and Senate bills will have a good change to pass by the July 4th recess,” Ormsby predicted.  Once passed, the legislative proposal will go to conference committee to iron out the differences between the 600-page House and 350-pshr Senate bills,” he said.

The prescription drug benefits are just a small portion of these massive legislative proposals, he noted.

Robert Greenwood, vice-president of public affairs for the National Pace Association, added: “Many Democrats see the limitation of these bills.  This legislation passed presents a historic opportunity to get this law on the book so it can be amended and improved in future years.”

While not a meaningful drug prescription proposal, it’s the first step in the right direction.

Once enacted into law, the Rhode Island congressional delegation must begin their efforts to improve the law – improve access for all: make out-of-pocket costs and cost sharing affordable; lessen gaps in coverage; more important, put the breaks to the steady increase in high-cost drugs.

Bipartisan Support Key for Passage of Aging Proposals

Published in Pawtucket Times on March 19, 2001

The operative word in national legislative circles these days in bipartisianship.

Both sides of the political aisle working together will have to be part of the picture if the long-term care field is going to see any significant legislative changes, policy sources indicate.

Why is that so? In the Senate, “there’s a 50-50 split between the two major political parties,” notes Bill Benson, President of Benson Consulting Group, a Maryland-based organization. What’s more, the division “has resulted in an unprecedented agreement between Senate Democrats and Republicans to share power,” according to Benson, a former top official with the U.S. Administration on Aging.

Democrats and Republicans alike have been following the failing health of Republican Senator Strom Thurmond, 98, of South Carolina.

If Thurmond retires or dies before the end of this term in 2002, it’s likely that his state’s Democratic governor would appoint a Democrat, a move that would shift the majority in the Senate to the Democratic Party.

Yet, Benson says that any legislative proposal would still need bipartisan support to get out of the Senate. “To get a Republican proposal enacted, you will either have to get lots of Democrats to cross party lines, or bring in Vice President Cheney to be a tie breaker,” he noted.

Meanwhile, in the House, the Republican majority holds but a razor thin margin.

“Like in the Senate, if both parties don’t work together in the House, you’re looking at legislative gridlock,” he says.

Benson notes that the Bush Administration is also moving to stall the lengthy regulatory and administrative actions taken by Clinton toward the end of his administration.

One such item that is temporarily halted is Clinton’s guidelines for managed care organizations that serve Medicare beneficiaries.

President Bush campaigned on Medicare reform and wants to bring his proposal to Congress.

His proposal provides a private sector alternative to traditional fee-for-service Medicare by offering block grants to states to help seniors pay for their pharmaceuticals.

This approach may be derailed by the Democratic Party, which added to its seats in Congress during the recent election, Benson explains.

He notes that Senator Charles Grassley (IA), Chairman of the Senate Finance Committee, has declared that he will not push Bush’s Medicare or prescription drug plans because they lack votes for passage.

Yet, Benson also predicts that the fact that Congress is closely divided increases the chance that something will be done about providing prescription drug coverage to seniors through Medicare. Otherwise, Benson adds, Medicare reform will amount to nothing more than talk this year.

Meanwhile, Robert Greenwood, American Health Care Association for Homes and Services for the Aging (AAHSA), says that bold, revolutionary proposals won’t be forthcoming from the nation’s evenly divided Congress.

Instead, legislators will take an incremental approach toward program development.

“A long term care agenda has not emerged yet,” Greenwood observes. “We don’t even have an administrator for the Health Care Financing Administration, the agency that manages the Medicaid program.”

Greenwood says, in the long run,” We’re hopeful that the Bush Administration will take seriously its responsibility to provide long-term care providers with the needed resources to provide quality of care and to fund a regulatory system that allows providers to do their job while still protecting vulnerable residents.”