Rationing Begins: States Limiting Drug Prescriptions for Medicaid Patients

Rationing Begins: States Limiting Drug Prescriptions for Medicaid
Patients

By Melanie Hunter
July 30, 2012
drudgereport.com

(CNSNews.com) – Sixteen states have set a limit on the number of
prescription drugs they will cover for Medicaid patients, according to
Kaiser Health News.

Seven of those states, according to Kaiser Health News, have enacted
or tightened those limits in just the last two years.

Medicaid is a federal program that is carried out in partnership with
state governments. It forms an important element of President Barack
Obama's health-care plan because under the Patient Protection and
Affordable Care Act--AKA Obamcare--a larger number of people will be
covered by Medicaid, as the income cap is raised for the program.

With both the expanded Medicaid program and the federal subsidy for
health-care premiums that will be available to people earning up to
400 percent of the poverty level, a larger percentage of the
population will be wholly or partially dependent on the government for
their health care under Obamacare than are now.

In Alabama, Medicaid patients are now limited to one brand-name drug,
and HIV and psychiatric drugs are excluded.

Illinois has limited Medicaid patients to just four prescription drugs
as a cost-cutting move, and patients who need more than four must get
permission from the state.

Speaking on C-SPAN's Washington Journal on Monday, Phil Galewitz,
staff writer for Kaiser Health News, said the move "only hurts a
limited number of patients."

"Drugs make up a fair amount of costs for Medicaid. A lot of states
have said a lot of drugs are available in generics where they cost
less, so they see this sort of another move to push patients to take
generics instead of brand," Galewitz said.

"It only hurts a limited number of patients, 'cause obviously it hurts
patients who are taking multiple brand name drugs in the case of
Alabama, Illinois. Some of the states are putting the limits on all
drugs. It's another place to cut. It doesn't hurt everybody, but it
could hurt some," he added.

Galewitz said the move also puts doctors and patients in a "difficult
position."

"Some doctors I talked to would work with patients with asthma and
diabetes, and sometimes it's tricky to get the right drugs and the
right dosage to figure out how to control some of this disease, and
just when they get it right, now the state is telling them that, 'Hey,
you're not going to get all this coverage. You may have to switch to a
generic or find another way,'" he said.

Arkansas, California, Kansas, Kentucky, Louisiana, Maine, Mississippi,
North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah and
West Virginia have all placed caps on the number of prescription drugs
Medicaid patients can get.

"Some people say it's a matter of you know states are throwing things
up against the wall to see what might work, so states have tried,
they've also tried formularies where they'll pick certain brand name
drugs over other drugs. So states try a whole lot of different things.
They're trying different ways of paying providers to try to maybe slow
the costs down," Galewitz said.

"So it seems like Medicaid's sort of been one big experiment over the
last number of years for states to try to control costs, and it's an
ongoing battle, and I think drugs is just now one of the … latest
issues. And it's a relatively recent thing, only in the last 10 years
have we really seen states put these limits on monthly drugs," he
added.

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