Date: 5/27/2009
RAY HENRY
Associated Press Writer
PAWTUCKET, R.I. (AP) — Joanne Devlin needs about 20 prescription drugs to regulate her blood pressure, keep her arthritic joints limber and pain-free and control her asthma.
She counts on financial help from Rhode Island when her Medicare Part D insurance plan maxes out and no longer pays her drug bills, which can reach $3,000 every three months. But that state help may no longer be an option after Jan. 1.
The financial crisis has grown so severe that lawmakers in Rhode Island and five other states have debated whether to cut or reduce the state funding that helps seniors and disabled people like Devlin buy their drugs.
Devlin, 62, who lives off about $10,000 a year, worries she may need to stop taking her arthritis medication to make ends meet. She stocks shelves and helps distribute food as a volunteer at a Salvation Army food shelter.
“I wouldn’t be able to move a lot,” she said. “I probably wouldn’t even be able to come here. I’d probably have to stay home and some days be bedridden, probably.”
Devlin’s predicament is shared by many of the nearly 27 million people enrolled nationally in Medicare Part D, the federal insurance plan that covers prescription drugs for seniors until the total bill reaches $2,700.
Seniors then hit what’s commonly called the “doughnut hole,” and must personally pay the drug bill until their out-of-pocket costs reach $4,350, at which point Medicare coverage resumes. When seniors fall into this gap, 16 states offer financial assistance, said Thomas McCormack, a consultant for the Community Access National Network and editor of the Medicaid Watch newsletter.
Other states offer help to help defray some of the premium costs associated with Medicare.
Eliminating the program in Rhode Island would save about $700,000 and affect around 8,000 people, while a proposal to scale back benefits in South Carolina would have trimmed roughly $7 million. Officials in South Carolina have estimated about 22,000 people are eligible for the program.
Those savings aren’t huge: they amount to less than 1 percent of the total budget in both states.
Vermont’s governor proposed eliminating the funding this year, but lawmakers instead instituted co-payments that cost recipients $1 or $2. New York and Connecticut rejected plans to curtail assistance, while Massachusetts has scaled back co-payment assistance for its seniors.
Advocates for the elderly fear the cuts will force cash-strapped seniors to stop taking their medications, leading to serious health problems.
“What we repeatedly see happen is that people stop taking their medications, they get sick, they end up in emergency rooms and the they get hospitalized for more serious health problems,” said David Certner, the legislative policy director for AARP.
“In the long-term, this is going to cost more money because it’s going to lead to greater health problems,” Certner said.
Bill Flynn, executive director of the Senior Agenda Coalition of Rhode Island, believes the Rhode Island proposal is the result of across-the-board budget cuts run amok.
“The approach in hard times should not be necessarily, ‘Well, everything’s on the table so low-income seniors need to suffer along with everyone else,’” he said. “The human cost of something like this could be pretty profound.”
In January — as South Carolina grappled with worsening unemployment and $1.1 billion in cuts to its $7 billion budget — the state slashed its doughnut-hole help for seniors from 95 percent to 10 percent.
Gov. Mark Sanford vetoed nearly all of a $5.7 billion budget, including all Medicaid and prescription drug spending, in a fight over using $700 million in federal stimulus money. By overriding his veto on May 20, lawmakers raised South Carolina’s doughnut hole coverage to 40 percent.
Sanford, who says it is unconstitutional for lawmakers to require him to use the stimulus cash, has responded by filing a federal lawsuit.
He said the vote to force him to seek the cash was unconstitutional and that he would fight it in court.
In Rhode Island, which is also wrestling with high unemployment and severe budget shortfalls, Gov. Don Carcieri has proposed cutting his state’s prescription drug program for seniors.
“It was a very difficult decision, and it’s strictly a budget decision,” said Corinne Russo, director of the state Department of Elderly Affairs, which runs that program.
Carcieri’s plan would eliminate next Jan. 1 the program that pays 60 percent of drug costs for its poorest enrollees and covers all their costs beyond $1,500. The assistance, which costs $1.5 million and serves more than 8,000 people, mostly targets the poor, Russo said.
About three-quarters of the state’s funding helps the poorest people enrolled in the program, the group Russo most worries might skimp on medication to make ends meets.
“Those are the people who are most at risk either of not purchasing medication or not being compliant with their medication regimen,” she said. “If a doctor says take one a day, they may take one every other day,” she said.
Compromises may keep the assistance operating. Carcieri’s administration is investigating whether it could use federal Medicaid funding to keep the program running, or perhaps restrict it to the neediest only.
Democrats hold a veto-proof majority in the state Legislature, allowing them to rewrite the Republican governor’s spending plans. But Rep. Steven Costantino, the Democratic chairman of the House Finance Committee, said he could not commit to saving it.
Lawmakers have asked Carcieri’s administration to present them with cost-saving alternatives to totally eliminating the program.
“We’re at the point where we need to ask everybody to sacrifice on this budget,” Costantino said.
And that frightens Anne Fortin, 72, who counts on the state’s help to help her pay for drugs that control her asthma and emphysema. Without it, her monthly drug bill would easily double to $400 or more.
“I could never pay that,” Fortin said. “I’ve been thinking about it. I said, ‘My God, what am I going to do?’”
___
Associated Press Writers Jim Davenport in Columbia, S.C., and John Curran in Montpelier, Vt., contributed to this report.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
HHS candidate best known for health care cuts
Date: 2/10/2009
By KEVIN FREKING and ERIK SCHELZIG
Associated Press Writers
WASHINGTON (AP) — Few governors know the pitfalls of soaring health costs better than Tennessee Gov. Phil Bredesen, which helps explain why President Barack Obama is reportedly considering the Democrat for health secretary.
In 2005, Bredesen cut 170,000 adults from Tennessee’s Medicaid program, called TennCare. He reduced benefits for thousands more.
Critics describe Bredesen’s actions as the biggest cuts in public health insurance in the nation’s history. They believe he’s the wrong person to lead an effort to expand health insurance coverage, and they’re throwing support behind other candidates, including Kansas Gov. Kathleen Sebelius, widely viewed as near the top of Obama’s list of candidates to run the Health and Human Services Department.
However, some say Bredesen’s stand shows he’s willing to tackle the toughest of problems.
Before the cuts were made, TennCare’s growth rate was making it harder to pay for education, roads and other critical services. Tennessee led the nation in the percentage of its population on Medicaid and the percentage of its budget going to Medicaid. However, on a per-person basis, Tennessee ranked 48th in state and local tax collections.
Dennis Smith, now a senior fellow at the Heritage Foundation, was in charge of Medicaid at the federal level in 2005. He said Bredesen’s actions were “necessary and appropriate” because the program was out of control.
For example, almost every state has some type of system that allows it to approve the amount and types of prescription drugs that beneficiaries get. Tennessee didn’t have such controls. Eligibility rules were also much broader than those of other states, allowing for enrollment of adults who would not have been eligible for Medicaid elsewhere.
The most praise for Bredesen comes from conservatives. Obama has shown a willingness to consider their views in his appointments so far, while many of those on the left of the issue say Bredesen is the wrong choice.
Bredesen emphasized in an interview Tuesday that he hasn’t applied for the HHS job or campaigned for it. But he has launched a counterattack against health care advocates for what he calls a distortion of the events that led to the TennCare cuts in 2005.
“Your name comes out and the next thing you know, people are dumping cans of garbage on you,” he said. “So I’m interested in, first of all, setting the record straight.”
Bredesen said the move to cut the number of TennCare enrollees came after advocates “absolutely pushed me to the brink” by blocking other proposals to rein in the costs of the program that was expected to grow by $680 million in just one year.
“Their mantra was, you can do anything you want, but you can’t reduce any benefits and you can’t remove any people,” he said. “They fought me every step of the way on ideological grounds, and basically pushed us to the point where we had no alternative to take some drastic action.”
The governor also downplayed the potential problem of having to work with groups who so vigorously opposed him. More important players will include pharmaceutical companies, hospital, doctors and medical equipment manufacturers, he said.
“What’s going to have to happen is not putting together a coalition of liberal advocacy groups for health care, but a coalition of real people who are sitting here on one-sixth of the U.S. economy and try to find some common ground,” he said.
In some respects, Bredesen sounds like former HHS Secretary Mike Leavitt when describing his philosophy for reforming health care.
“I certainly believe there’s an underlying right and the federal government ought to be financing a basic level of health care for everybody,” Bredesen said.
Bredesen’s emphasis is on the word basic. Leavitt repeatedly stressed the same emphasis. He listed as his top priority that “every American has access to basic health insurance at an affordable price.”
Bredesen met with Obama for the first time in his Washington office shortly after Obama announced he would seek the Democratic nomination for president in 2007.
Bredesen in 1980 founded a health maintenance organization called HealthAmerica Corp., which became the country’s second-largest HMO before he sold it in 1986 for about $400 million.
___
Associated Press writer Erik Schelzig reported from Nashville, Tenn.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
By KEVIN FREKING and ERIK SCHELZIG
Associated Press Writers
WASHINGTON (AP) — Few governors know the pitfalls of soaring health costs better than Tennessee Gov. Phil Bredesen, which helps explain why President Barack Obama is reportedly considering the Democrat for health secretary.
In 2005, Bredesen cut 170,000 adults from Tennessee’s Medicaid program, called TennCare. He reduced benefits for thousands more.
Critics describe Bredesen’s actions as the biggest cuts in public health insurance in the nation’s history. They believe he’s the wrong person to lead an effort to expand health insurance coverage, and they’re throwing support behind other candidates, including Kansas Gov. Kathleen Sebelius, widely viewed as near the top of Obama’s list of candidates to run the Health and Human Services Department.
However, some say Bredesen’s stand shows he’s willing to tackle the toughest of problems.
Before the cuts were made, TennCare’s growth rate was making it harder to pay for education, roads and other critical services. Tennessee led the nation in the percentage of its population on Medicaid and the percentage of its budget going to Medicaid. However, on a per-person basis, Tennessee ranked 48th in state and local tax collections.
Dennis Smith, now a senior fellow at the Heritage Foundation, was in charge of Medicaid at the federal level in 2005. He said Bredesen’s actions were “necessary and appropriate” because the program was out of control.
For example, almost every state has some type of system that allows it to approve the amount and types of prescription drugs that beneficiaries get. Tennessee didn’t have such controls. Eligibility rules were also much broader than those of other states, allowing for enrollment of adults who would not have been eligible for Medicaid elsewhere.
The most praise for Bredesen comes from conservatives. Obama has shown a willingness to consider their views in his appointments so far, while many of those on the left of the issue say Bredesen is the wrong choice.
Bredesen emphasized in an interview Tuesday that he hasn’t applied for the HHS job or campaigned for it. But he has launched a counterattack against health care advocates for what he calls a distortion of the events that led to the TennCare cuts in 2005.
“Your name comes out and the next thing you know, people are dumping cans of garbage on you,” he said. “So I’m interested in, first of all, setting the record straight.”
Bredesen said the move to cut the number of TennCare enrollees came after advocates “absolutely pushed me to the brink” by blocking other proposals to rein in the costs of the program that was expected to grow by $680 million in just one year.
“Their mantra was, you can do anything you want, but you can’t reduce any benefits and you can’t remove any people,” he said. “They fought me every step of the way on ideological grounds, and basically pushed us to the point where we had no alternative to take some drastic action.”
The governor also downplayed the potential problem of having to work with groups who so vigorously opposed him. More important players will include pharmaceutical companies, hospital, doctors and medical equipment manufacturers, he said.
“What’s going to have to happen is not putting together a coalition of liberal advocacy groups for health care, but a coalition of real people who are sitting here on one-sixth of the U.S. economy and try to find some common ground,” he said.
In some respects, Bredesen sounds like former HHS Secretary Mike Leavitt when describing his philosophy for reforming health care.
“I certainly believe there’s an underlying right and the federal government ought to be financing a basic level of health care for everybody,” Bredesen said.
Bredesen’s emphasis is on the word basic. Leavitt repeatedly stressed the same emphasis. He listed as his top priority that “every American has access to basic health insurance at an affordable price.”
Bredesen met with Obama for the first time in his Washington office shortly after Obama announced he would seek the Democratic nomination for president in 2007.
Bredesen in 1980 founded a health maintenance organization called HealthAmerica Corp., which became the country’s second-largest HMO before he sold it in 1986 for about $400 million.
___
Associated Press writer Erik Schelzig reported from Nashville, Tenn.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
