The choice is simple and desperate: Buy a needed prescription drug for a heart ailment or pay the light bill; choose blood-pressure medicine or food. For some poor elderly in Maine, it’s a calculated risk — sometimes they take their medicine and sometimes they eat, and the result not only is inhumane but costly to everyone.

Maine’s current low-cost prescription drug program covers only five illnesses for people at least 62 years old who earn $10,336 or less. Approximately 9,000 Mainers currently qualify for the program, which costs $3.4 million annually. A bill before the Legislature, LD 2218, would dramatically expand coverage to all prescription drugs for the same age group but who earn up to 185 percent of the poverty line, $14,597 for singles and $19,629 for couples. The expanded version would cost a total of $10.4 million annually.

That cost, however, is deceptive, as recent legislative testimoney showed. Dr. Steven Soumerai of Harvard University recently explained the results of his study on the effects of limiting low-cost access to prescription drugs to the elderly in New Hampshire. In brief, he found that when the elderly could not afford to pay for medicine, the state needed to provide significant increases in emergency mental health services, and the number of people needing (government-supported) nursing-home care doubled. When New Hampshire restored its drug subsidy, these numbers receded to their previous levels.

Dr. Soumerai’s conclusion was clear: Making sure that elderly patients can afford to take their medicine is a cost-effective move. “In comparison to other health care technologies,” he said, “medications represent the most essential care for such vulnerable populations that can offset intensive and, often, expensive services.” He added that in his costs for denying drug subsidies to the elderly he did not count the cost of pain and suffering, risks of suicide or the costs to the criminal justice system incurred by people with untreated schizophrenia.

After hearing conclusions like these and, more importantly, testimony from elderly Mainers who cannot afford medicine, a task force on improving access to low-cost prescription drugs assembled a package that would help both the ill and the taxpayer. Should be a simple yes vote for the Legislature, but there’s a catch. The King administration says it cannot get the necessary Medicaid waiver to match the state funds with needed federal health dollars. No sense approving a bill if there’s not enough money to fund it, the administration understandably concludes.

But rather than let a good bill be defeated needlessly, find a way around the problem. Amend the bill so that its provisions take effect only if a Medicaid waiver is granted. If Maine tries for the waiver and fails, nothing has been lost. If the state can make its case, as it should, that access to prescription drugs saves federal dollars for the same reason that it saves state dollars, then Maine should be successful.

In that case, everybody wins. All it will take is for legislators and the King administration to cooperate.