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.

2020 Census Data Impacts Federal Funding Allocated to Aging Programs and Services

Published in the Woonsocket Call on January 19, 2020

By April 1, every home across the nation will receive an invitation from the U.S. Census Bureau, a nonpartisan government agency, to participate in the 2020 Census. Once this invitation arrives, it’s important for you to immediately answer the short questionnaire by either going on-line, phone, or by mail. When you respond to the census, you’ll tell the Census Bureau where you live as of April 1, 2020.

The U.S. Constitution: Article 1, Section 2, mandates that the country conduct a count of its population once every 10 years. The 2020 Census will mark the 24th time that the country has counted its population since 1790

The population statistics generated by the upcoming 2020 Census will be used to distribute over $700 billion annually in federal funds back to tribal, state and local governments. The collected census data also determines the number of seats each state has in the U.S. House of Representatives, provides insight to governments, business and community planning groups for planning purposes, and finally defines congressional and state legislative districts, school districts and voting precincts

2020 Census Statistics and the Graying of America

According to a blog story published on Dec. 10, 2019, by American Counts (AC) Staff, the upcoming 2020 Census will provide the federal government with the latest count of the baby boom generation, now estimated at about 73 million. The boomer generation born after World War II, from 1946 to 1964, will turn 74 next year. When the 2010 census was taken, the oldest had not even turned 65.

Baby Boomers are also projected to outnumber children under age 18 for the first time in U.S. history by 2034, according to Census Bureau projections. With an increasing need for caregiver and health services and less family caregiver support, the boomers will be forced to depend on federally-funded support services, their allocation depending on policy decisions based on census data.

“Data from the 2020 Census will show the impact of the baby boomers on America’s population age structure,” said Wan He, who has for over 21 years overseen the Aging Research Programs for the Population Division of the U.S. Census Bureau.

AC’s blog article, part of a Census Bureau series detailing the important community benefits that come from responding to the 2020 Census questionnaire, stresses that exact count of American’s age 65 and over is important for tribal, local, state and federal lawmakers to determine how they will spend billions of dollars annually in federal funds on critical aging programs and services for the next 10 years.

While everyone uses roads, hospitals and emergency services some state and federal programs specifically target older Americans – the 2020 Census statistics will be used to distribute funding to senior centers, adult day care facilities, nutrition programs including meals on wheels, and the Supplemental Nutrition Assistance Program, job-training programs, elder abuse programs, Medicare Part B health insurance and Medicaid, the health insurance program for low-income people including those age 65 and older.

“The census is really important to us in the aging community,” said John Haaga, of the National Institute on Aging in Washington, D.C. in the AC’s blog article. “It’s our only way to figure out how things are different across the country, what areas are aging faster, where elderly disabled people live, or where older people are concentrated, like Appalachia or West Virginia, because young people are leaving for the cities,” says Haag, noting that “Older people are remaining behind there.”

Haaga noted, “Other states, such as Florida, have large older populations because people are moving there to retire.”

“You can start to look at specifics like how many older people are living alone who are more than 10 miles from an adult day care centers,” says Haaga. “You can answer questions of access and how to improve it,” he adds, noting that census statistics helps lawmakers or business people decide where to open health clinics or senior citizen centers, among other services.

Calls for Action: Fill Out that Census Questionnaire

AARP has three main goals, according to State Director Kathleen Connell. “First,” she said, “to ensure a fair and accurate census count by educating our​ members and older adults about the census outreach efforts. Second, to provide tips and resources to encourage safe participation while protecting themselves from bad actors and census related fraud during this time. And third, to help people age 50 and over gain employment as census enumerators.”

“AARP has long been involved in informing people about the census, including the fact that the headcount is labor intensive – to the tune of 400,000 temporary staff. In the past, retired adults have made up a good portion of those who work in the decennial count of Americans, often as enumerators who go door-to-door in neighborhoods. In many communities, the Bureau will be looking for bilingual applicants.”

To be sure, Connell adds, the loss of a Congressional seat would have an impact on Medicare funding and other services that support Rhode Island’s age 50 and over population. “If a subset of people doesn’t participate in the census, the area in which they live will be represented as having fewer residents than it actually does; the costs to states and communities could be large, consequential and long-lasting. A census that is as complete and accurate as it can be – and doesn’t undercount the number of residents in a given area – is a vital resource for everyone,” she said.

Connell sits on the RI Complete Count committee and the AARP State Office is using its email list and social media in a series of reminders and encouragement to participate in the census. AARP also is reaching out to members who might consider becoming census workers.

Adds Jennifer Baier, AARP Senior Advisor, Census lead: “Many federally funded programs rely on census data to distribute billions of dollars to states and localities across the country. According to the George Washington Institute of Public Policy, Rhode Island receives about $3.8 billion per year based on Census data. That includes funds for schools, roads and hospitals and also programs that aid older Americans, such as Medical Assistance Program (Medicaid) Medicare Part B, Special Programs for the Aging, Meals on Wheels, Heart Disease Prevention Programs and more.”

“The 2020 Census is just nine questions long, and takes about 10 minutes to fill out – those ten minutes impact millions of dollars of federal funding in every state and communities across the country,” says Baier.

Quality of Life Amenities Make Providence a Great Retirement Mecca

Published in Woonsocket Call on August 30, 2015

Today’s retirement age is not set in stone at 65 years old for aging baby boomers, the milestone age where their parents and grandparents retired from the workforce.  Retirement Confidence Studies are finding that retiring in your mid-sixties is not a sure bet for many. According to WalletHub, a leading personal finance website, one such study, the Employee Benefit Research Institute’s 2014 Retirement Confidence Survey, found that  23 percent of workers expected to retire at age 65, but only 11 percent actually were able to.

The latest EBRI survey, released last April, said that many respondents blamed the nation’s poor economy for the continuing need to work in their later years. Others pointed to “inadequate finances” as another key reason for not retiring.  For 51 percent of workers and 31 percent of retirees, their accumulated debt kept them at their jobs.

WalletHub adds, the Report on the Economic Well-being of US Households in 2014 prepared by the Board of Governors of the Federal Reserve System, says that 24 percent of the survey respondents are not at all confident at having enough money to finance a comfortable retirement.  The government report also noted that 50 percent cited cost of living and daily expenses as obstacles for putting money into their retirement egg nest.

WalletHub calls for a strategy to slide into a more comfortable retirement for those whose nest egg is small, just relocate to a City to “stretch your dollar without sacrificing your lifestyle.”Sars by Relocation

WalletHub decided to pinpoint the most cost efficient and retirement-friendly places in the country because of the research studies indicating that feelings of financial insecurity have an impact on how retirees make decisions to save for retirement, says WalletHub Spokesperson, Jill Gonzalez.

For the second year in a row, WalletHub, conducted an in-depth analysis of the Best and Worst Cities to Retire.  Like last year, the financial website compared the affordability, quality of life, health care and availability of recreational activities in the 150 largest U.S. cities.  The compiled data included 24 metrics, ranging from the cost of living to public hospital rankings to the percentage of the population aged 65 and older.

“Our methodology makes the difference. It’s extremely well-researched and the metrics are developed in conjunction with academic experts that span several fields,” says Gonzalez.res

WalletHub’s 2015 Best and Worst Cities to Retire ranks Rhode Island’s Capitol City almost dead last as the worst place to retire. But, the City of Providence did place better than two of his cities, Jersey City and New Jersey.  

Some of the metrics compiled from this survey include: Adjusted Cost of Living (122); Annual Cost of In-Home Services (140); Elderly Friendly Labor Market (80); Number of Adult Volunteer Activities per Capita (23); Percent of the Population Aged 65 and Older (132); Emotional health (144); Violent Crime Rate (78); and number of Home Care Facilities per capita (129).

Gonzalez noted that like 2014, in this years’ survey WalletHub compared the retirement-friendliness of the 150 most populated largest U.S. Cities (excluding the surrounding metro areas) across four key dimensions: Affordability; Activities; Quality of Life; and health Care.  Twenty four relevant metrics were complied, ranging from the cost of living to the percentage of the elderly population to the availability of recreational activities.

“Every year we strive to improve our methodology by taking into account consumer feedback and industry trends,” adds Gonzalez.

It’s no surprise that when a financial web site publishes rankings, older industrial cities in the Northeast are at a disadvantage,” said AARP Rhode Island State Director Kathleen Connell.

“Some of the indicators where Providence comes up short are discouraging. However, many of the city’s greatest attributes – its arts and culture environment, community esources associated with world-class institutes of higher learning, proximity to Narragansett Bay and convenient travel distances to Boston and New York are but a few of the reasons people stay after retirement.

“There should be no confusing Providence with the state as a whole as a retirement choice. Granted, Rhode Island is more expensive than the sunbelt and in states where the housing market collapse has resulted in more affordable housing alternatives. And energy costs will always be higher in our region. That said, many downsizing retirees who value quality of life find a way to make it work. Others can’t, and we need to find ways to make retiring here more affordable. Eliminating the state tax on Social Security benefits was a step in the right direction, albeit in real dollars not a game changer for many retirees with limited resources. Affordable senior housing is a big issue and one of those challenges that requires urgent attention,” Connell added.

“The WalletHub analysis is useful insofar as it raises awareness and compels people to think more about retirement – and that includes both retirees as well as policymakers.”

“Although the WalletHub’s study is well conducted and well-respected in the financial sector, you have to look deeper into each of the categories when it comes to Providence,” says Edward M. Mazze, Distinguished University Professor of Business Administration, at the University of Rhode Island.  “There are some unique factors that make Providence a better place to retire than one would guess from the survey,” he adds.

Mazze explains that economists who list, through national surveys, the best retirement places generally emphasize three criteria, specifically the cost of living, income, property and sales taxes and state/inheritance taxes. “When considering only these criteria, Providence and most cities will not rank high,” he says.

According to Rhode Island’s widely acclaimed economist, the state has made significant improvements in changing the income tax rates, raising the bottom on estate taxes and removing some social security benefits from state taxes which makes Providence a “great place to retire from a quality of life standpoint.”

For those retirees who want to live in a city that has four seasons, is strategically located near other major cities like Boston and New York, and want an active life-style, Providence meets the criteria,” he says.

Providence’s downtown area is also a site of parades, festivals and celebrations, says Mazze, adding that after enjoying these activities, retirees can dine at world-class restaurants.  You might also add to your list the close access to over 100 beaches and 400 miles of coastline, bike and nature trails and historic sites.

While WalletHub’s survey may not show Providence as a top place to retire, the quality of life factors would ratchet up Providence into a higher rating.