Prescription panned

October 08, 2006

Rising prescription drug costs have become a backbreaking burden on Maryland's middle- and low-income families - and there's no simple solution to the problem. But last year, state legislators devised a modest plan to help an estimated 37,000 people pay their drug bills. It was far from a panacea, but it was a start.

Last week, the federal government shot it down. The decision by the Centers for Medicare and Medicaid Services to deny Maryland's application to offer prescription drugs at Medicaid prices to qualifying uninsured adults is a big setback for the state's efforts to assist the uninsured. The program posed no additional burden for the federal government, but by tapping Medicaid's purchasing power, participants (uninsured adults earning below $19,140 or families of four earning $38,700 who are not Medicaid-eligible) would have received an estimated 40 percent discount on drug prices.

The reasoning by CMS is puzzling. In a letter to Maryland Health and Mental Hygiene Secretary S. Anthony McCann, CMS Administrator Dr. Mark McClellan writes that he must deny the application because the state does not propose spending any non-federal money on the benefit, a violation of federal law. But that's simply untrue. The state had planned to subsidize the benefit - the exact level would be set by Secretary McCann to conform with federal requirements. Maryland's share would be financed by the $2 million or so CareFirst BlueCross BlueShield of Maryland pays the state in lieu of a state tax on health insurance premiums.

The rejection is hardly a surprise. The Bush administration has been a reliable supporter of the drug manufacturers. Those companies clearly had the most to lose if Maryland's program was accepted, particularly if other states started doing the same thing. The lower prices might eventually cost drug makers tens of millions of dollars in profits.

But Secretary McCann should not take no for answer - nor should Gov. Robert L. Ehrlich Jr., who signed the original bill into law, or legislators, who approved the program overwhelmingly in 2005. The decision should be appealed or an amended application submitted as soon as possible. It's bad enough that CMS took a year to say no to the original proposal.

Too many Maryland families choose each day between paying for prescription drugs and paying for rent or other necessities for state officials not to continue to fight for lower drug prices.

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