Rationing Begins: States Limiting Drug Prescriptions for Medicaid Patients

CNS News ^ | 7/30/2012 | Melanie Hunter

[IbJensen]

CNSNews.com) – Sixteen states have set a limit on the number of prescription drugs they will cover for Medicaid patients, according to Kaiser Health News.

Seven of those states, according to Kaiser Health News, have enacted or tightened those limits in just the last two years.

Medicaid is a federal program that is carried out in partnership with state governments. It forms an important element of President Barack Obama's health-care plan because under the Patient Protection and Affordable Care Act--AKA Obamcare--a larger number of people will be covered by Medicaid, as the income cap is raised for the program.

With both the expanded Medicaid program and the federal subsidy for health-care premiums that will be available to people earning up to 400 percent of the poverty level, a larger percentage of the population will be wholly or partially dependent on the government for their health care under Obamacare than are now.

In Alabama, Medicaid patients are now limited to one brand-name drug, and HIV and psychiatric drugs are excluded.

Illinois has limited Medicaid patients to just four prescription drugs as a cost-cutting move, and patients who need more than four must get permission from the state.

Speaking on C-SPAN’s Washington Journal on Monday, Phil Galewitz, staff writer for Kaiser Health News, said the move “only hurts a limited number of patients.”

“Drugs make up a fair amount of costs for Medicaid. A lot of states have said a lot of drugs are available in generics where they cost less, so they see this sort of another move to push patients to take generics instead of brand,” Galewitz said.

“It only hurts a limited number of patients, ‘cause obviously it hurts patients who are taking multiple brand name drugs in the case of Alabama, Illinois. Some of the states are putting the limits on all drugs. It’s another place to cut. It doesn’t hurt everybody, but it could hurt some,” he added.

Galewitz said the move also puts doctors and patients in a “difficult position.”

“Some doctors I talked to would work with patients with asthma and diabetes, and sometimes it’s tricky to get the right drugs and the right dosage to figure out how to control some of this disease, and just when they get it right, now the state is telling them that, ‘Hey, you’re not going to get all this coverage. You may have to switch to a generic or find another way,’” he said.

Arkansas, California, Kansas, Kentucky, Louisiana, Maine, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah and West Virginia have all placed caps on the number of prescription drugs Medicaid patients can get.

“Some people say it’s a matter of you know states are throwing things up against the wall to see what might work, so states have tried, they’ve also tried formularies where they’ll pick certain brand name drugs over other drugs. So states try a whole lot of different things. They’re trying different ways of paying providers to try to maybe slow the costs down,” Galewitz said.

“So it seems like Medicaid’s sort of been one big experiment over the last number of years for states to try to control costs, and it’s an ongoing battle, and I think drugs is just now one of the … latest issues. And it’s a relatively recent thing, only in the last 10 years have we really seen states put these limits on monthly drugs,” he added.

[In Maryland]

"Contrary to what the communists who are running and ruining this country say, the rights are “Life, Liberty and the Pursuit of Happiness.”

That’s all folks!

I don't know what copy of the Constitution you have, but the one I refer to has these 10 amendments (Called the "Bill of Rights") that give me a few more rights. But health care is not mentioned in those, either.

[engrpat]

How soon before Medicare adopts the same rules?

[Notary Sojac]

I actually agree with that. If I were President, I would absolutely offer to buy back your Medicare card, for the full amount paid in by employee and employer for Medicare, plus 5% compound interest.

This would come with the agreement that you would never, repeat never, be eligible for one single penny's worth of health care services from the government for the rest of your life. Money runs out? No hospital, no doctor, no medications for you.

Run the numbers and see how big a check you would get, before you jump at the offer.

[Notary Sojac]

As with any gift, it is the giver and not the receiver who determines the extent of the gift.

Precisely.

Which is why, when a government agency proposes to reduce benefits rather than raising taxes, we should at least recognize the possibility that this is a prudent use of taxpayers' money, and not immediately shriek "OMG!!! Death Panels!!!"