Elimination of Adult Prescription Drug Benefit Proposed As Budget Cut

The state's Medicaid agency has recently submitted proposed 5% and 10% budget cuts to the Governor's Office at her request, which include termination of such programs as the Basic Health plan, non-emergency Adult Dental services, Disability Lifeline and Interpreter Services.

As the majority of required services provided under Medicaid is mandated by federal law, the Health Care Authority is unable to implement a true across-the-board cut.  Rather, it is a combination of state-only-funded programs and optional federal Medicaid programs. The 10% target totals $446 million;  5% totals $223 million. 

Even more damaging, however, these numbers still leave the agency short of the 10 percent target by an estimated $127 million; proposed is a complete suspension of the Medicaid adult prescription drug benefit for a period of up to 18 months to cover that shortfall.

The pharmacy cut would impact about 500,000 adults – mostly seniors and people with disabilities – out of Medicaid’s 1.2 million clients.  
UPDATE 10/6/2011: The Health Care Authority has indicated that pharmacy services will remain a Medicaid covered item for recipients served by ADSA.  It is critical, however, that this intention is followed up with implementory statutory language.  We will be monitoring this situation closely. 

Several of the cuts would also adversely impact funding for small rural hospitals around the state. Proposals include a revision of the payment methodology for Critical Access hospitals and a parallel reduction to the Certified Public Expenditure program for hospitals. 

Contact pmontgomery@agingwa.org for compete details.