Politicians split on Rx strategy

AUGUSTA – Democratic efforts in Maine to convince President Bush and the Republican-dominated Congress to repay millions to the state for health care costs are not going over well with GOP legislative leaders, who have dismissed the attempt as “symbolic” and “unnecessary.”

“I don’t know what particular relevance there is for a state legislature sending a resolution to Congress,” said House Republican leader David Bowles of Sanford. “We know our congressional delegation is working on this, so I just don’t know what value or meaning a resolution from the Legislature would have.”

Maine House Speaker John Richardson, D-Brunswick, and Senate President Beth Edmonds, D-Freeport, said last week that pushing a resolution through the Legislature to express the state’s dissatisfaction with the federal government’s management of the Medicare Part D prescription drug program would be the first order of business when lawmakers return to work Feb. 28.

The 122nd Legislature is in recess during this school vacation week, although legislative leaders have left it up to committee chairmen to decide whether their panels should continue meeting or not. Richardson and Edmonds have set a March 10 deadline to report all bills out of legislative policy standing committees in an effort to meet an April 19 statutory adjournment deadline.

Richardson said he and Edmonds had thought “long and hard” about what the Legislature should do about the problems within the Medicare Part D program, an initiative they both agree has “failed to get up and running like most people thought that it would.”

The state estimates it has paid up to $100,000 a day for medications to cover its poorest residents when they were not listed as being enrolled in the new federal program or when those residents couldn’t afford the co-payments they were erroneously being charged.

“We have agreed to submit a joint resolution requesting that the president and the Congress reimburse the state for expenses associated with fixing the federal government’s mismanagement of the implementation of the Medicare Part D program,” Richardson said.

Joined in a press conference last week by Senate Majority Leader Michael Brennan, D-Portland, and Rep. Hannah Pingree, a North Haven Democrat and co-chairman of the Legislature’s Health and Human Services Committee, the two presiding officers emphasized Maine already had spent $5 million on prescriptions for the program.

Acknowledging there had been improvements since the system was introduced Jan. 1, Richardson said 15,000 Mainers still are having problems getting their prescriptions filled.

Gov. John E. Baldacci met with Federal Health and Human Services Secretary Michael Leavitt last month in Augusta in an attempt to correct conflicts in the program the administration claimed is costing the state $33,000 to $100,000 a day.

Leavitt told Baldacci the federal government would repay Maine for the added costs of making sure eligible Mainers obtained the medications they needed up to Feb. 15, when federal officials expected to have the problems corrected.

Last week, however, the governor pointed out that an estimated 15,000 Mainers were still having problems getting their prescriptions through the federal program. He asked federal officials to promise to reimburse the state for an additional three weeks until the problems could be fully resolved. Maine’s congressional delegation also has sent a letter in support of the extension.

Democratic leaders in the Legislature said their joint resolution not only would support the extension request, but also would demand that the Bush administration pay Maine back for the so-called “clawback” provision in Part D.

Under the new federal program, senior citizens whose incomes are low enough to qualify them for Medicaid as well as Medicare are supposed to have their prescriptions covered by Medicare Part D instead of by state programs. The federal government has estimated how much each state should save under the new program and assessed them a fee, referred to as the “clawback,” to help pay for the new program.

Maine officials, however, argue that the federal figures don’t reflect how well the state had done in keeping drug prices down under its Medicaid program. They say the federal government is overstating the savings Maine is being required to pay back by about $9.2 million.

State officials also have pointed out that its own drug programs provided better coverage of medications for participants than the new federal plan. Maine’s Medicaid program, for instance, covered about 6,000 different drugs, while the new Medicare program requires coverage of about 450.

“Maine is being forced to pay more for less coverage to its seniors,” Richardson said.

“We are being lumped in with other states who have not done what they needed to do in providing for their people, and so we are being penalized for, in fact, providing better care for our folks,” Edmonds added.

Despite Republican skepticism over the effectiveness of a joint resolution on Medicare Part D, Democrats such as Pingree insist all states have to do whatever they can to underscore the problems in the federal program. She added there was no reason the strategy should divide the parties.

“I think that between the governor’s office and the Legislature, this is not partisan – every state is hurting because of this, and they’re angry about being passed a bill for a benefit that treats their citizens in a worse way,” she said. “This resolution is our way of reinforcing that Maine thinks the federal government needs to go back and fix this.”

Bowles agreed that all states are concerned about any reduction in federal support at any level, but added there was bipartisan support in Congress for approval of the Part D policy in the first place. Assistant Senate Minority Leader Carol Weston, R-Montville, said the fact the president sent Leavitt to Maine to meet with Baldacci was a strong demonstration of the White House’s intent to repay the state for its health care costs.

“But for the Legislature to sort of say, ‘Hey, wait for me, I want to get in on this, too,’ is maybe just that,” Weston said. “I think we ought to let Secretary Leavitt do his work.”