Medicaid Part D Payment Crisis (As Written)

February 4, 2006

Governor Gregoire: Secretary Leavitt, I am grateful to you for coming out to Washington. My state, like every other state, has been experiencing a crisis since January 1, when 96,000 of our most vulnerable citizens were forced into the new Medicare Part D program.

This population is living with serious mental and physical health problems. They are now required to get their drugs from any one of more than twenty Medicare-approved Prescription Drug Plans operating in Washington State. In addition, this population is being required to pay a co-pay of anywhere from $1 to $5 for every prescription they need. Now remember, on Medicaid they had no co-pay. As of January 1, on Medicare, they do.

A dollar to $5 may not sound like a lot to some. But these folks are living on $579 or less per month. In Washington State, the average number of prescriptions a dual eligible takes is seven, and many take 15 or more. $35 to $75 per month is a huge barrier to accessing life-saving, life-stabilizing medications.

Some in this population are so entirely dependent on medications to maintain their quality of life that they cannot go for a day without them. And yet, with the new federal requirement that they pay co-pays for these medications, this is exactly what has happened and these individuals are facing a life-threatening situation.

Mr. Secretary, you are here to credit $14 million to Washington State to ensure that the most vulnerable among us continue to have access to their needed medications. I thank you for that. There are a multitude of transition issues that must be dealt with; but setting those aside for the moment, it is the co-pays that serve to be the greatest barrier to this population receiving medications. I have spoken to the Legislative leadership, they have agreed for one year to appropriate the $14 million of state money to pay for these co-pays. This is going to help these individuals immensely.

Let me give you a sense about the real people in Washington State who are suffering and who will be helped:


  • A 75-year-old husband and wife who take 30 drugs between the two cannot afford the co-pays they are suddenly being charged, so they will go without.

  • The Area Agency on Aging in Southwest Washington reports getting calls from clients so distraught about Part D that they threatened suicide. These are similar to hundreds of other calls the state is fielding every day.

  • One critical and terminally ill man was enrolled in a plan and his pharmacist could not access his identification number or group number. The man did not get his medications and had to be hospitalized.

Again, let me be clear. This is just the beginning. I am committed to working with you and with my federal delegation to find permanent solutions to what I feel is a fundamentally flawed federal program. These individuals cannot afford the co-pay and the state cannot keep picking up the tab.

As you know, my federal delegation has been incredibly engaged in this issue in Washington, DC. The majority of my delegation voted against the Medicare Modernization Act in 2003; but they continue to fight to make the program far more robust. I especially give credit to Senators Cantwell and Murray who have been dogged in their fight at the federal level to make the impact of this transition easier on all Medicare beneficiaries, and with particular attention to the dual eligible population.

I will continue to work with Senators Cantwell and Murray and the entire Washington delegation to repeal the co-payment requirement for dual eligibles from federal statute, as well as any other section of the Medicare drug program that is serving as a barrier to Washingtonians receiving the health care they need and deserve.

Our pharmacists have been great, and truly, the heroes through all of this. I commend and thank them for helping this population through this transition.

Aain, Secretary Leavitt, Thank you for being here. The $14 million is going to go a long way in serving the most vulnerable in my state.


###