Baldacci’s Assistant Testifies Before Committee
WASHINGTON, March 2 – Gov. John Baldacci’s representative pleaded Maine’s pecuniary plight caused by the new Medicare prescription drug benefit program before the Health Subcommittee of the House Energy and Commerce Committee Wednesday.
Jude Walsh, the governor’s special assistant in his Office of Health Policy and Finance, told the subcommittee that Maine has had to pay some $6 million to cover the drug costs of those Mainers who did not receive the coverage that they should have under Medicare Part D. That’s the new prescription benefit that went into effect Jan. 1 and has been plagued by what Republican members of the subcommittee called “glitches.”
“The federal drug benefit was not ready Jan. 1 and is still not ready for everyone today,” Walsh testified before the subcommittee, of which Rep. Thomas Allen (D-1 st District) is a member. Walsh said the Centers for Medicare & Medicaid Services “never would have allowed a state Medicaid program to implement a benefit as flawed as this one remains.”
While the new benefit is intended to give many seniors and poor people access to medications that they did not have last year, much of the problem in the program’s first weeks had to do with the plight of former Medicaid recipients who were automatically assigned to the new Medicare program and found themselves at least temporarily deprived of government drug benefits.
Critics see the new program as corporate welfare for the pharmaceutical and insurance industries.
“Speaking for my constituents in Maine, I have to say the process has been chaotic,” Allen said. “The Medicare Modernization Act of 2003 gave the pharmaceutical and insurance industry most of what they wanted. But it denied senior citizens and people with disabilities the simple option of adding a Medicare-administered drug plan to their existing benefits.”
Dr. Mark McClellan, the administrator of the Centers for Medicare & Medicaid Services, agreed that Medicare Part D gives less coverage than some employer plans, but he said that seniors now had a wide range of choices, up to 50 depending on the area, and that help is available in choosing the plan that best fits their needs.
One of the biggest criticisms Democrats at the hearing had was that the original legislation was drafted by industry lobbyists and congressional Republicans.
“It was conceived in sin, born in the darkness of night with no participation by Democratic members at all and was attended only by a fair gaggle of lobbyists of the health care industry, the insurance industry and the pharmaceutical industry,” Rep. John Dingell (D-Mich.) said.
Republicans countered by saying the market is working to provide seniors with choice and the lowest prices, and called the Democrats’ plan for government price negotiations with the industry a relic of the “command economy.”
“The horse that’s actually being ridden on the other side is a unicorn,” Rep. Steve Buyer (R-Ind.) said. “Because it’s pure fantasy to believe that if you’re going to have price control in America that we’re going to be the land that creates these blockbuster drugs that will provide quality of life to people not only here but throughout the world.”
Walsh said there also were problems in the implementation of the new program. Many pharmacists around the state reported that as many as 50 percent of their customers who had sought the benefit could not be confirmed as participating.
The state set up a hotline to air these grievances, and at the turn of the year as many as 15,000 people called every day, Walsh said. Many of the callers said they were having to pay $250 deductibles and $100 co-pays after they were moved automatically into the new program.
Baldacci responded by reauthorizing the state’s pharmacy benefit, which so far has spent $6 million on 115,000 prescriptions for more than 50,000 Mainers. The Centers for Medicare & Medicaid Services has promised to pay this back, but that has not happened yet, Walsh said.
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