Medicare Prescription Drugs and Low-Income Beneficiaries

Low-income Medicare beneficiaries are a vulnerable population because of their disproportionately high medical and long-term care needs. Among low-income beneficiaries are nearly seven million individuals who are considered “dual-eligibles,” with coverage from both Medicare and Medicaid. They represent around one in six Medicare beneficiaries and one in seven Medicaid beneficiaries.

The recently passed Medicare prescription drug bill transfers responsibility for providing prescription drug coverage to dual eligibles – from Medicaid to the new Medicare Part D. How will dual eligibles now receiving Medicaid drug benefits be affected by the new law? How about low-income beneficiaries not now receiving Medicaid benefits? How will existing state prescription drug programs be changed? How much fiscal relief will the new law bring to state Medicaid programs?

To help address these and related questions, the Alliance for Health Reform and the Kaiser Commission on Medicaid and the Uninsured sponsored a December 15, 2003 briefing. Speakers reviewed provisions in the new Medicare bill concerning dual eligibles and looked at the implications from a number of perspectives. They were: Vern Smith of Health Management Associates and a former Medicaid director; Robert Hayes of the Medicare Rights Center; and Howard Cohen of HC Associates, a former congressional staffer specializing in Medicare and Medicaid. Ed Howard of the Alliance and Diane Rowland of the Kaiser Commission, moderated the discussion.