HEALTHIER HEALTHY MAINE

Even if the federal courts don’t cooperate by reversing an earlier decision on Healthy Maine Prescriptions, Sen. Susan Collins was right earlier this week to urge Health Secretary Tommy Thompson to move forward and endorse the updated version of the program. Maine government also has work to do on the plan that reduces drug costs for low- and middle-income residents for up to 25 percent.

The U.S. Court of Appeals ruled Dec. 24 that the Maine program exceeded federal rules because Maine could not require drug manufacturers to offer rebates when neither the state nor the federal government made a Medicaid contribution. After a similar plan in Vermont was rejected by the court a year ago, Maine decided to pay for 2 percent of the costs, but this amendment is not in state statute and had not been formally approved by Secretary Thompson. The court, therefore, ignored the change.

There is no guarantee that the court would allow the program even if both the federal and state amendments were made, but it stands no chance without them. More than 110,000 people have used this discount program; another 90,000 are eligible. It amounts to huge savings for people without drug coverage and, done right, could be a model for other states. Maine has every reason to take into account the court’s comments and anticipate further arguments by drug manufacturers.

Sen. Collins observed, “I have long believed that states can be extremely productive laboratories for change and that the federal government should encourage them to undertake innovative programs such as Healthy Maine Prescription.” Indeed, without a lot more energy on the federal level for comprehensive health-care reform, the most likely alternative is change at the state level, which can then be copied by other states. If the federal government cannot help, it should at least not become an impediment. That means the secretary should formally recognize all the components of the plan.

Maine policy-makers should make the 2 percent state contribution a required part of the drug program but they should also ask whether this is enough. Phrma, the drug lobbying group that brought the suit against the state, says it is not, and given the industry’ success in fighting the discount, Maine will need either a strong argument that the 2 percent is sufficient or find a new number.

There’s no reason the recent loss in district court cannot be used to refine and strengthen Healthy Maine, and it is important to poor consumers that it or a similar program survives. The key is to keep pushing federal and state officials to respond to the court’s demands.