Skip to comments.Rationing Begins: States Limiting Drug Prescriptions for Medicaid Patients
Posted on 07/31/2012 9:04:32 AM PDT by 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-SPANs 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. Its another place to cut. It doesnt 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 its 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, youre 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 its a matter of you know states are throwing things up against the wall to see what might work, so states have tried, theyve also tried formularies where theyll pick certain brand name drugs over other drugs. So states try a whole lot of different things. Theyre trying different ways of paying providers to try to maybe slow the costs down, Galewitz said.
So it seems like Medicaids sort of been one big experiment over the last number of years for states to try to control costs, and its an ongoing battle, and I think drugs is just now one of the
latest issues. And its a relatively recent thing, only in the last 10 years have we really seen states put these limits on monthly drugs, he added.
We must eliminate Obamacare!
I'm guessing -- call me crazy! -- that this might inhibit the supply of available services. Not to mention blocking any possible advances within the field.
I disagree strongly with Alabama's decision to not cover psychiatric drugs - lord help us, we have enough crazy people on the streets as it is! Stopping psychiatric drugs is not only a medical issue, but a public safety one.
These hospitals better stop the wagon because it’s all going to be flushed in November. Actually it’s already having an effect against Obama in the election. As the idiots who voted for him finally get the drift of what they are facing in Odingacare.
......and what about King Bozo Oostberg’s LGBT Lobby and restricting HIV drugs, eh?
The health care plan I have had for more than 40 years through my employer, now my former employer, has always had the restriction of, if a generic is available and you choose the name brand, you pay a much higher co pay. It makes perfect sense to me.
......and what about King Bozo Oostberg’s LGBT Lobby and restricting HIV drugs, eh?
Yo, Galewitz, get back to me when you end up in that group.
You know how libs are always making comments at times when you can’t rebut them politely?
I was telling someone about a family that took bankruptcy over medical bills for their child who was born sickly and required a lot of medical care to keep him alive.
My lib-in-law commented in the other room that it was a great thing we had 0bamacare now so that these situations wouldn’t happen, no one would have to take bankruptcy over medical bills for a child.
Of course, the answer is that the IPAB wouldn’t have approved of treatment for the newborn, so he would have died. Of course, this would have avoided bankruptcy, now, wouldn’t it?
This is nothing new.
Medicare is already rationing.
It’s not a case of being a fussy ‘begger’. Drug effectiveness is a big one, and so are allergic reactions. Not all generics are created equal. People DIE when their asthma medication doesn’t work.
Soon, EVERYBODY will be facing these issues if Obama care takes hold. It won’t be just ‘beggers’. We will ALL be beggers who will pay through the nose for something we aren’t getting.
I agree. When name brand and generic are the same go generic. I take a thyroid med that has no generic - Medicare will not cover it.
That’s the problem. Some desk jockey is making medical choices without reason.
My understanding is that HIV treatment can be extremely expensive - as with any disease, I think the state has a right to insist on sane, cost-effective treatment. But just because HIV is mainly (but not entirely) associated with homosexuals and intravenous drug users, I don't feel treatment should be denied. Neither do I feel that this one disease category has a "right" to the most expensive, state-of-the-art "Cadillac" treatments. So HIV should be covered just as other non-curable illnesses are, neither better nor worse.
But I also said: "There should probably be an appeal process for the limited number of cases where there is a good reason why a name brand drug must be used." I realize there are people who legitimately need more expensive brand-name drugs. But they are a small minority.
I am a LPN nurse and have been studied Nutrition and Medicine. I have found that most of the drugs given senior citizens are poison and not needed. For an example Statin drugs. I wrote a blog on it
The Cholesterol Myths
All this brought to you by the same fools that made the rules that brought us the lending institution meltdown, that practically destroyed our nation.
Ooooohh goodie, I can’t wait.
I agree 100%, but it is the Regime who are going to regulate these prescriptions...in the end...
Pretty soon Massachusetts is going to need a program to provide bus fare for their people to get to New Hampshire to see their doctors.
Obviously during the campaign it needs to be made clear to the working people of this country that Obamacare means worse healthcare for them so the deomcrats can re-distribute that money for use for the healthcare of those who expect the government to provide for them. Young people need to understand they will be grossly overcharged for their insurance in order to subsidize retirees.
Thank you. Statins are poison. They create more age related disease than anything, other than possibly BP medicines. I have steadfastly refused to take Statins against doctors wishes for 20 years and will continue to refuse them. It has been my experience that most things respond just as well or better to “natural” or alternative methods as they do to drugs. Researchers have found that Cholesterol does not cause heart attacks & strokes. The stats are just not there for the premise. If I had begun taking the Statins 20 years ago I would probably be dead by now from kidney or liver disease. Instead I am a healthy 79 with high Cholesterol which gives me no problems. Sure, I might have a stroke or heart problem, but aren’t all persons my age at risk for those?
For some reason I initially misread your statement as you were in strong agreement. Fortunately just my bad eyes and I don't have to engage in a big fight with you! Not to say there aren't some problems with certain psychiatric drugs and their abuse -- but blanket denial is irresponsible and dangerous for the public, especially in the case of anti-psychotic drugs. Also, I'd hate to be a patient on SSRIs and be abruptly cut off (been there, done that, for other reasons). Sudden discontinuation syndrome is no joke.
Wait a minute - I thought that the current system was "unfair" because there were all these free-loaders who didn't pay for coverage?
Now you tell me ObamaCare is increasing the number of free-loaders??
Good for you. Statins are poison and they destroy your liver. If you watch your sugar intake, you will cut down on a lot of the ills of our age. The American Diet consists of no nutrition at all except for sugar. Insulin resistance causes everything from aging, cancer, heart problems, dementia, Alzheimer’s, High blood pressure. Oh throw in a little coconut oil or any saturated fat which is really only coconut oil.
You have broken the odds against your getting sick good luck.
Besides their cardiovascular effects, statins may slow the progression of kidney disease.
Look up "GREACE" study.
Good luck to you. I hope those aren't "famous last words" in your comment toward the end.
Only in rare instances. Early on it was thought there might be a high incidence of deleterious effects. This turned out to be illusory. Many physicians have discontinued the enzyme screenings or do them only infrequently now (the latter is probably the prudent course of action).
Well, what will happen is what has happened in every country with socialized medicine, including places like Sweden and Canada. Those with political connections will get the good drugs and the expensive procedures and get moved to the front of the line, while the others will get the generics and wait for even basic tests and operations.
Right now, my loser nephew gets treated the same as I do. We both get prompt, excellent treatment.
As I have said I am not qualified to give advice. I have although read about many current studies that do show serious S/E from taking statins. The medical world, I’m sure is not aware of these private group controlled test. Nor do they want to be.
It’s no wonder these asshats that have ruined our nation and our lives want to disarm us!
Think Madrid, 1936!
Is health care a right possessed by all Americans?
Is health care a right possessed by all Americans?
Can you tell me what Medicare is rationing?
I have a thyroid medicine they will not cover, because someone somewhere has decided that I should use a generic brand, except that this particular thyroid medicine does not have a generic.
I was on my husbands employee health care plan the day I turned 65 I was dropped, I was told because of obamaCare.
Forced onto medicare.
Thank the Kenyan for America’s medical problems!!
I correctly predicted the court would not overturn ZeroCare and I will further predict that none of this will be overturned by Romney, it might be renamed but they have spent hundreds of Billions on implimenting this abomination and it is no more likely to go away than a temporary tax increase.
Of course not.
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!
And the central socialist government shouldn’t be socialist and should be a shadow of its former self! It should never tax the hell out of working people to give to some lazy-assed blob who doesn’t even know what the Constitution is and couldn’t name the first president of the United States, who happened to be the BEST president of the United States whose picture USED to hang in every classroom of every school I attended until University.
It therefore follows that those who are getting their health care from Medicaid (and to a partial extent Medicare) are receiving that care at the sufferance of the taxpayer.
And as that taxpayer, I damn well want rationing, if the alternative is an unlimited raid on my wallet.
Then ‘healthcare’ ,as provided to those suckers like me who paid several hundred thousand dollars into the ponzi scheme known as social security, should be abolished for the newer workers. In fact, abolish the abortion for all! I do want some of the money (a meager amount) returned to me from a central socialist government who stole it from me, plus the amount they mugged my employer for.
This is an evil nation with evil schemes all designed to pull America into the socialist swampland.
However, as a humane society we provide benefits to poor people. These benefits are a gift that taxpaying Americans have agreed to give to (in general) the financially disadvantaged, because of our basic decency as human beings. As with any gift, it is the giver and not the receiver who determines the extent of the gift. Or who should, anyway.
Thats 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.
How soon before Medicare adopts the same rules?
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.
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!!!"