Prescription drugs aren’t good for you if they stay in the medicine cabinet and prescription drug programs aren’t good for you if they can’t be used. Maine’s years of work to reduce the price of prescription drugs, particularly for the low income elderly, came down to this the other day: An 83-year-old woman went into a drug store in Bangor and found her cost for heart medication had quintupled because the program she had depended on was killed in court and the state hadn’t negotiated enough new contracts or told the people who depended on the program what had happened.

That this is a life-threatening oversight is beyond question. The problem applies to the 77,000 people who benefited from the Healthy Maine program, who lost their benefit as of April 15. They will temporarily gain them back through May 1, after the Department of Human Services decided the short notice of the previous end date was too much of a shock, but the problem of a lack of affordable prescription drugs returns after that.

Low-income residents may be able to afford some of their medication, they may find some cheaper alternatives or have a doctor who can temporarily supply them with a needed drug. But chances are excellent that many will not find any of those options and will be forced to do without medications. DHS knew for months that because Healthy Maine and its blanket discount on drugs was ruled illegal in federal appeals court last December, it would have to negotiate successfully with drug companies individually to obtain the discounts. It did that in many cases but failed to in many more: 86 manufacturers, including some of the world’s largest, refused to participate. DHS then compounded its error by failing to adequately notify pharmacists and the people who used the program. The result is thousands of people suddenly caught by huge increases in drug costs. The new deadline was an encouraging change – for the next two weeks.

There is a larger issue here as well. Maine is only one of many states trying to create discount drug programs to compensate for the utter failure of Congress or the White House to pass effective legislation on the issue. But the frailty of the state programs is clear from Maine’s experience – or experiences, Maine Rx isn’t looking all that healthy right now either. Because different states have different programs the savings are not what they could be, and the possibility of shifting federal rules imperil state programs without much states can do about it.

Maine Reps. Michael Michaud and Tom Allen recently announced their intention to make Maine Rx a national program. Republicans largely yawned. Sens. Susan Collins and Olympia Snowe were successful in moving an expansion of generic drugs and a Medicare drug plan through the Senate last year, but they did not pass in the House. Maine’s delegation is not alone in trying to find an answer to the lack of affordable prescription drugs, but the fact Congress has been unable to present a coherent and comprehensive plan to make medicine available to all of the nation’s poor is a disgrace.

When Congress fails, the states try to fill in. Sometimes they are successful – and sometimes the cost of heart medication quintuples overnight.