Prescription coverage is needed

Sunday, June 29, 2003

By Dwight Fine

JEFFERSON CITY, Mo. -- In March, I met with the Southeast Missourian's editorial board about Missouri's budget crisis, the Missouri Hospital Association's concerns about coverage of the uninsured and possible solutions to these problems.

One solution the MHA proposed was that the federal government assume responsibility for the prescription drugs used by Missourians who are eligible both for Medicare and Medicaid. Congress now is considering Medicare prescription-drug legislation that would address this concern.

I urge you to study the U.S. House of Representatives' version of this legislation, House Resolution 2473, and support it.

The underlying problem with our Medicaid program stems from the state's subsidy of populations that rightfully should be covered by the federal Medicare program, which was created to provide care for the elderly and disabled. Of Missouri's 181,000 elderly and disabled Medicaid population, 158,000 also are enrolled in Medicare.

Most of the money Missouri spends on its low-income elderly and disabled citizens covers nursing-home care and prescription drugs. In prescription drugs alone, the state's dually eligible populations costs the state and federal government approximately $429 million a year. Of that, the state's share is $166 million.

Missouri taxpayers have been paying these costs for the elderly and disabled because, even though most of these beneficiaries are enrolled in Medicare, it does not cover extra needs such as prescription drugs.

The MHA has been urging Congress to enact a Medicare prescription-drug benefit that would assume the states' costs for providing this coverage to the elderly and disabled. HR 2473 would help provide prescription drugs to the uninsured while relieving the state of the responsibility of subsidizing these costs -- a responsibility states, including Missouri, no longer can afford.

If HR 2473 becomes law, it would make a tremendous difference to low-income Missourians. Federal prescription-drug coverage as provided in the bill would allow Missouri to affordably support the remaining Medicaid programs important to the elderly and disabled and provide care for low-income children and some working adults who cannot afford private health-care insurance.

Dwight Fine is the senior vice president for governmental relation at the Missouri Hospital Association.

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