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5/18/2007
Yes Virginia, SeniorCare really IS more expensive...
In the paragraphs below, Representative Kevin Petersen (R-Waupaca) debunks near-universal whining about the federal government’s failure to extend Wisconsin’s widely touted prescription drug program. JE
During the last election, I promised to take care of seniors. Just as I have worked on protecting veterans, now is the time to honor my promise to ensure low-income seniors get the life-saving medications they need.
For the first three months of this year, we all read piles of media reports about why the federal government should extend SeniorCare, Wisconsin’s prescription drug program for seniors. But on April 3rd, the Federal Department of Health and Human Services released a letter to Governor Doyle outlining why the state’s SeniorCare waiver (the only one in the U.S.) would not be extended.
Three main explanations were cited in HHS’s denial letter sent to the governor.
Explanation #1: “Because the State failed to submit critical information for us to evaluate, we have no basis to conclude that SeniorCare is budget neutral to the federal Medicaid program.”
The federal government spends on average of $617 per SeniorCare participant. This figure is about half as much as the $1,174 it spends per Medicare Part D participant. With only these two pricing figures, it’s natural to wonder why the government would not extend the waiver.
The key words in the previous sentences are “federal government spends”. What is overlooked is the fact that Wisconsin taxpayers contribute approximately $65 million per year (about $613 for each participant) to supplement the federal payments. The federal plus the state contribution equals a $1,230 cost for each individual currently on SeniorCare. The difference in cost ($56) times the 90,000 SeniorCare members using the program equals $5,040,000 spent above the federal Medicare Part D program. Hence: SeniorCare is NOT cost neutral.
Explanation #2: “Despite repeated requests, the State has declined to describe how SeniorCare participants who qualify for the low-income subsidy under Medicare Part D program would be moved to Part D. Many seniors in Wisconsin are clearly disadvantaged by their continued participation in SeniorCare because of the lower cost sharing required in the Medicare Part D program.”
Using SeniorCare provisions and a variety of Medicare D details as the basis for detailed computations (which my office is glad to provide if you have an interest), it can be shown that nearly 33,000 seniors enrolled in SeniorCare Level 2 have overpaid for their prescription medications since January of 2006.
Explanation #3: “Without [the] information to identify who the demonstration is serving, again we are unable to make the necessary budget neutrality determination. As you know from other demonstration projects and waivers the state operates, identifying the population that is served is a basic and fundamental requirement. We cannot merely accept the State’s assertion that SeniorCare participants do not meet the Medicare Part D asset test requirements.”
Asset test requirements, not verified by SeniorCare, would separate approximately 57,000 “Level 1” participants who truly do need our help in obtaining prescriptions from those who would otherwise contribute to their medication costs.
If you are enrolled in SeniorCare or knows someone who is a participant, please phone my office at (888)947-0040 or e-mail me for help with needed information and assistance required during the upcoming transition to WisconsinCare.
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• Lots of ideas. No money.
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• AASD Retirement Costs Burdensome
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