Asian Pacific AIDS Intervention Team logoCompassion in Action
NewsNews

NMAC Alert on Medicare - Medicaid

DUAL ELIGIBLE NEED AFFORDABLE and COMPREHENSIVE PRESCRIPTION DRUGS COVERAGE!

SITUATION: As the cost of health services and prescription drugs spirals out of control, health coverage security for low-income people living with HIV/AIDS (PLWH/A), seniors, children and other individuals with severe chronic disabilities who qualify for both Medicare and Medicaid is repeatedly jeopardized. Currently approximately 6.2 million individuals qualify for both Medicare and Medicaid services. This group of beneficiaries formally, referred to as "dual eligibles", accounts for almost 42 percent of all Medicaid spending.

House Bill 1 - The Medicare Prescription Drugs and Modernization Act of 2003 (H.R. 1) and Senate Bill 1 - Prescription Drug and Medicare Improvement Act of 2003 (S. 1) are currently being negotiated by the House and Senate. Though in theory both bills were designed to create affordable prescription drug programs under Medicare, only H.R. 1 would grant all Medicare beneficiaries, including the dually-eligibles, access to the program. On the contrary, the Senate bill (S.1) would force all low-income seniors, children, PLWH/A and other severe chronic disabled to seek prescription drug benefits under Medicaid. The second bill, would be a landmark policy shift, discontinuing Medicare as a universal program for all individuals 65 years or older regardless of income. The adoption of such a policy change would have a devastating impact on beneficiaries of color and people who require the most medical care.

STATUS: Since June 27th the House and Senate have been holding joint meetings to negotiate a "compromised" Medicare Prescription Drugs Bill. Policymakers hope to complete this process by November 21st, the targeted day for Congress to adjourn.

PROBLEM: There is a strong possibility that a compromise bill will prohibit states from covering the cost of Medicare prescription drug premiums for dual eligibles through state-based Medicaid initiatives or "wrap-around benefits." If adopted, this provision would leave hundreds of thousands of people without the assistance needed to access life extending medications.

TAKE ACTION!

Contact your Senator(s) and Congressional Representatives: http://www.appropriations.senate.gov http://www.house.gov/appropriations

TALKING POINTS:

  • Low income people living with HIV/AIDS, seniors, children and other people with severe disabilities should not be bounced around from one program to another.
  • Enact a sound and fair national prescription drug policy that meets legitimate health and prescription drug needs of all individuals regardless of age, income or disability status.
  • Eliminating Medicaid wrap-around prescription drug assistance would represent a reversal of progressive policy-making. PLWH/A are very grateful that all 50 states have elected to provide this optional Medicaid service.
  • Low-income seniors and individuals with disabilities need coverage under both Medicaid and Medicare. They have the greatest health related needs due to the severity and complexities of illnesses and life threatening diseases.
  • Dual eligibles should not bear the brunt of escalating health related services and prescription drugs.
  • For additional background and educational information: www.familiesusa.org