(Host) Lawmakers are concerned that a new Medicare prescription drug bill could cost the state millions of dollars. Members of an oversight committee heard on Wednesday that the new federal law is likely to erode the benefits that some Vermonters now receive.
VPR’s John Dillon has more:
(Host) The new federal law, called the Medicare Modernization Act, is incredibly complex. The regulations designed to implement the law run over 2,000 pages. The law establishes for the first time a drug benefit under Medicare. But it’s impact on states like Vermont that already provide benefits could be disastrous because Vermont will no longer get federal matching funds for its own drug benefit programs.
(Donna Sutton Fay) “It’s going to be huge from a budgetary standpoint. And it’s going to have a huge impact on beneficiaries.”
(Dillon) Donna Sutton Fay is the state’s health care ombudsman, or independent advocate. She told a joint health care oversight committee that the state needs to prepare now for when the law takes full effect in January 2006.
Benefits for about 13,000 Vermonters are threatened. And it could cost the state up to $10 million a year to fill the gap in coverage. The Douglas administration, which supported the law, has promised to make up the difference with state dollars. But Sutton Fay told the lawmakers that the issue is complex because there’s likely to be changes in coverage between existing state Medicaid benefits and the new federal Medicare programs.
(Sutton Fay) “I think it’s very likely that Medicaid beneficiaries are not going to have nearly the same coverage under Medicare that they do under Vermont Medicaid. And many of them are going to find themselves in the position of having had a particular drug covered under Medicaid that’s not going to be covered under the particular plan that they have.”
(Dillon) Prescription drugs were also on the agenda for Governor Jim Douglas on Wednesday. The governor unveiled a new purchasing pool that he says would use the power of the market to allow businesses to band together and negotiate discounts from drug companies.
Douglas also reiterated his promise to those who are now on the state prescription drug program.
(Douglas) “They will not lose their benefits. I am committed to ensuring that the Vermonters who participate in our VScript program are held harmless. The new Medicare law takes effect in January 1 of ’06, so we have time to work out the solution to that challenge. It might come in a waiver requested through the Department of Health and Human Services.”
(Dillon) But Joshua Slen, the director of the state’s office of health access, told lawmakers that the federal government has not welcomed waiver requests from states.
(Slen) “That’s what we’ve been told. And I have a monthly call with our waiver contacts at the federal level and we’ve asked this question repeatedly for the last several months. And we’ve gotten the same answer from them: submit anything you like on this issue, but it’s just going into a special circular file.”
(Dillon) The issue will have to be resolved by the next Legislature. Chittenden County Democratic Senator Jim Leddy, who chairs the Senate health committee, supports the governor’s plans to protect Vermonters. But Leddy wants more details about where the money will come from, or if other health benefits will have to be cut to pay for the pharmacy program.
For Vermont Public Radio, I’m John Dillon in Montpelier.