Sen. Richard Moore and Rep. Patricia Walrath, co-chairs of the Joint Committee on Health Care Financing, joined the ACT!! Coalition to sponsor a press conference today on “minimum creditable coverage” (MCC) and prescription drug coverage. With 100 people in attendance — including Rep. John Scibak, Rep. Jim Marzilli and Rep. Steve D’Amico — the group heard a diverse panel of speakers explain why MCC must include a prescription drug benefit.
Speakers included two nationally renowned experts on drug coverage from Harvard Medical School – Dr. Jerry Avorn and Dr. Stephen Soumerai. Dr. Avorn explained that insurance without drug coverage is like a hospital johnny – poorly designed, cheaply made that leaves you exposed. Dr. Avorn said eliminating drug coverage to reach a quick fix to the problem of affordability “is no solution at all. … Prescriptions are at the center of modern medicine.” Dr. Soumerai insisted “insuring health without access to medicines is impossible.” Dr. Soumerai quoted studies showing that concerns about cost caused more than 50 percent of adults with chronic illnesses and without drug coverage to forgo prescribed medications, resulting in “a significant decline in health status” and an increase in adverse events (Click here for Dr. Avorn’s statement, and click here for Dr. Soumerai’s statement).
Rep. Walrath expressed surprise the Connector would consider not requiring drug coverage. Sen. Richard Moore, who was unable to attend, stated in a letter to the Board: “to exclude prescription drug coverage is, essentially, to exclude mental health benefits” and will lead to increased cost-sharing for patients (click here for Senator Moore’s letter). Richard Boyajian, a Nurse Practitioner, and Neil Cronin, of the MA Law Reform Institute, spoke about their personal experiences with illness, stating that without access to medication they literally would not be alive. John Auerbach of the Boston Public Health Commission (click here for his letter) highlighted the essential role of drugs in protecting public health and Toby Fisher, Executive Director of NAMI Massachusetts, explained that medications are a critical part of treatment for those with mental illness. Rev. Hurmon Hamilton from the Greater Boston Interfaith Organization said plans without drug coverage are not affordable; affordability must be measured by more than premiums.
Thanks to everyone who was able to attend and also to those who wrote letters in support of requiring prescription drugs to the Connector Board. About 25 statewide organizations and leaders have written letters to the Connector Authority urging inclusion of prescription drugs as a standard benefit.
Apparently, the opinion of people like Leslie T. are not taken into account by the so-called “we know best for everyone” folks at Health Care for All. Leslie T. is right on when she says that drug coverage should absolutely be an option, but not a requirement. In this case, Leslie T. saved $4200 in one year by foregoing the rx drug coverage that she didn’t need anyway and would have had a hard time paying for. It’s time that HCFAMA gets off the soapbox and realizes that it is impossible to have it all but not pay for it (as many bloggers have already pointed out).
The problem with requiring drug coverage is that it’s so darn expensive. I am retired, not yet eligible for Medicare, so I’m paying out of pocket for nongroup coverage via Harvard Pilgrim. When I turned 60, I had a choice between retaining drug coverage and paying $1000/month, or dropping the drug coverage and paying $650/month. I’m comfortable, but not wealthy, so the $350 difference was significant for me, especially since I’m not currently taking any prescription drugs (knock on wood). So I dropped the drug coverage. It’s hard to grasp the fact that the law might require me to go back to paying $1000/month.
Let’s have the plan offer a drug coverage option, but please make it an option, not a requirement.
Does anyone really argue that prescription drugs have no health benefits? I don’t think that’s the question on the table. The Connector Authority is trying to do three things: (1) hold firm on the individual mandate, (2) provide affordable products for low income workers whose earnings are above 300% of the poverty line, and (3) provide comprehensive coverage. Putting together the information you have published on this blog, its seems clear that the Connector can do two things at once, but not all three. Which one do you want them to compromise on?