A spoonful of help

August 01, 2007

Congress and the Bush administration have been awfully kind to the pharmaceutical industry in recent years. Now it's time for taxpayers to get a little something in return. Legislation expected to be introduced today by Maryland Rep. Chris Van Hollen would allow uninsured low- and moderate-income adults to buy drugs at Medicaid prices.

That's a reasonable idea, and it could make health care a little more affordable for as many as 400,000 Marylanders. Low-income adults currently pay top dollar for prescription drugs - if they can afford them at all. People covered by private insurance or by Medicaid don't have this problem, of course. But for Maryland's uninsured adults to qualify for Medicaid benefits, they have to earn less than 40 percent of the federal poverty level - $8,260 per year for the typical family of four.

Gov. Robert L. Ehrlich Jr. signed into law a similar program in 2005, but the Bush administration declined to issue the necessary Medicaid waiver (as the administration declined similar programs in Maine, Vermont and Minnesota). It's still not entirely clear why. Drug manufacturers strenuously objected to the idea because it would cut into their profits, and they have considerable clout in the nation's capital.

The discount would certainly be a great deal for the federal government, which would incur no cost. It would also be of great help to the uninsured - Medicaid prices generally run 40 percent below retail. And Mr. Van Hollen's bill would allow that benefit to be extended to adults earning up to three times the poverty level - $61,950 in the case of a family of four.

Drug companies may view this as price-fixing, but it's just using the clout of bulk purchasing. And making drugs more affordable is likely to broaden the market, so what companies lose in markup will be at least partially offset in sales volume.

At minimum, it's a concrete way to help working families who can't afford insurance and don't otherwise qualify for government benefits. Washington's record on drug pricing is woeful - rejecting proposals to allow Medicare to negotiate lower drug prices and to allow the importation of less-expensive drugs from overseas.

Extending the Medicaid discount might not be a cure for all that ails America's health care system, but it would be a prudent - and affordable - start.

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