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States should be paid for drug bills: lawmakers

Posted on: Thursday, 19 January 2006, 18:25 CST

By Joanne Kenen

WASHINGTON (Reuters) - With about half of the U.S. states now paying for prescription drugs for poor and elderly caught in Medicare drug snafus, lawmakers on Thursday demanded that the federal government step in to reimburse them.

The calls in Congress came mostly from Democrats, joined by a few moderate Republicans. Republican governors have also complained about implementation of the drug benefit, which started on January 1.

The focus has been on the more than 6 million "dual eligibles" who qualify for both the Medicaid program for the poor and the Medicare program for the elderly and disabled.

"They are the sickest of the sick, the frailest of the frail," West Virginia Democratic Sen. Jay Rockefeller, who has tried for two years to address what he said were inevitable problems with the poorest elderly, told a news conference.

Many of the poor were either not enrolled properly or were randomly assigned to plans that did not include the drugs they need. About 25 states and Washington, D.C., are paying for the medications, and some pharmacies are also absorbing costs.

Senators calling for the federal government to pay the multimillion-dollar tab include both those who like Rockefeller opposed President George W. Bush's Medicare drug plan from the start, as well as some centrists who voted for it such as Republicans Norm Coleman of Minnesota and Olympia Snowe of Maine.

The Democrats said at a news conference they did not know what all the state spending totaled, but cited such examples as $15 million for New Jersey and $70 million for California in a program that is less than three weeks old.

BURDEN ON STATES

"States are very concerned because they've stepped in and they've been told that these costs won't be reimbursed," said Scott Pattison, executive director of the National Association of State Budget Officers. "It may be a small percentage of state budgets, but it's still a lot of money that they hadn't planned on spending."

Administration officials running the Medicare drug program have acknowledged difficulties with the roll-out, but have said the program is working for millions of people. They have said states should not expect payment from Washington but instead should deal with the many private insurers who are providing the new benefit.

The administration has said the private companies that are providing the drug benefit should pay for 30-day supplies of any drug a beneficiary was already taking.

Democratic senators said the federal government can recoup the costs from the private health plans offering the Medicare benefit, but they do not want 50 different states to have to deal with dozens of different insurers that are under contract to Washington, not the states.

In the House, Maryland Democrat Ben Cardin plans to introduce companion legislation later this month but an aide said he does not yet have any Republican co-sponsors.

Iowa Republican Sen. Charles Grassley, the Finance Committee chairman and a co-author of the drug law, opposed any legislative fixes right now but said he would closely watch how the administration and health plans address the problems.

"It's unacceptable that some of the poorest, sickest people are having the most trouble, and it's not what Congress intended," Grassley said in a statement.

(Additional reporting by David Lawder)

Source: REUTERS

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