January 5, 2006
States Coordinate Pharmaceutical Assistance Programs With New Medicare Prescription Drug Benefit, New NCSL Report Shows
DENVER – Some 42 million Americans now have access to the federal Medicare Part D prescription drug coverage that went into effect on January 1. A new report by the National Conference of State Legislatures details how states have revamped their existing pharmaceutical programs to coordinate with the federal plan, in many cases providing more services or fewer charges to enrollees.
State Pharmaceutical Assistance Programs in 2006: Helping to Make Medicare Part D Easier and More Affordable is online at www.ncsl.org/programs/health/SPAPCoordination.htm. The report shows that state approaches to mesh their programs with Medicare Part D fall into four categories: enhancing Medicare with state funds that once paid for state prescription drug programs; redirecting some state-funded prescription drug services to people not covered by Medicare; eliminating state benefits that will now be covered by the federal program; and terminating state programs.
- At least 16 states are supplementing Medicare Part D with funding that used to pay for their own programs. Another five – Alaska, Hawaii, Kentucky, Montana and New Hampshire – have put in place new "wrap-around benefits" to plug some of the gaps in the federal program. More than 1.5 million beneficiaries are eligible in these 21 states. Wrap-around programs often pay all or part of the beneficiary’s $250 annual deductible, $32 monthly premium or gaps in coverage and copays that can add up to $2,500. Some also cover products not covered by Medicare, among other approaches.
- Several states have shifted resources to provide coverage for populations that don’t qualify for Medicare. For example, Arkansas, Illinois, Maryland, Montana, New Mexico and Oklahoma have enacted new plans aimed at adults under 65 or families.
- Almost all programs reduced or eliminated those state benefits that are now available through the federal program. Most enrollees did not see their coverage reduced as a result. As of January 1, Part D beneficiaries with annual incomes below $13,000 have no premiums or coverage gaps. Wyoming will drop from its program all those who are eligible for the federal counterpart. It will continue to cover those state enrollees who aren’t eligible for Medicare.
- Five states have terminated their state-funded programs, which were generally similar to the federal one. They are Florida, Kansas, Michigan, Minnesota and North Carolina.
This report will be updated twice a month as new information becomes available.
NCSL is the bipartisan organization that serves the legislators and staffs of the states, commonwealths and territories. It provides research, technical assistance and opportunities for policymakers to exchange ideas on the most pressing state issues and is an effective and respected advocate for the interests of the states in the American federal system.
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