Maine case
threatens isle plans

Hawaii's new laws on prescription
drugs are like Maine's, which
are being challenged

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By Bruce Dunford
Associated Press

Gov. Ben Cayetano says he will ask Attorney General Earl Anzai to look into having Hawaii join Maine in defending its prescription drug discount-buying program before the U.S. Supreme Court.

The high court agreed yesterday to decide how far states can go in negotiating lower prescription costs by hearing the drug companies' challenge of Maine's pioneering law in this area.

On May 31, Cayetano signed into law bills for state-sponsored drug discount-buying programs for the uninsured and the poor that were patterned after Maine's 2-year-old law.

"I think it's in our interest to support Maine in this case," Cayetano said yesterday. "This is another issue where it'll be interesting to see how the Supreme Court supports the right of the states to take measures like this, so it's a very important case."

Cayetano had earlier expressed hope that the Supreme Court would let stand an appeals court ruling that upheld Maine's law. That also was the hope of the Bush administration.

State Rep. Roy Takumi (D, Pearl City-Waipahu) a leading architect of Hawaii's two laws, said having the Supreme Court take up the case could be seen as good news because he is confident the Maine law will be upheld and open the way to implement Hawaii's law.

While he wants the state to join Maine in defending its law, Takumi said he believes the more important support will come from the Bush administration.

Like the Maine law, one of the Hawaii laws would provide the Medicaid prescription drug prices to lower-income residents who do not qualify for Medicaid programs. The other would set up a state-sponsored bulk-buying program to give Hawaii residents lower prices, but that will not take effect until 2004.

The appeals court had rejected arguments from a drug industry trade group that the Maine program unconstitutionally regulates transactions in other states and conflicts with federal Medicaid law. The high court will review the case next year.

If allowed to take effect in Maine and Hawaii, the programs would extend prescription drug benefits offered under Medicaid -- the federal insurance program for the poor -- to the working poor or others whose incomes, while low, do not qualify for Medicaid.

Under the Maine plan, companies would be pressured to sell drugs to uninsured customers at the same discounted price the government pays for Medicaid patients. The state would penalize drug companies that refused by requiring doctors to get prior approval before prescribing one of those drugs to a Medicaid recipient.

Meanwhile, the U.S. House agreed early yesterday to spend $320 billion over 10 years to offer seniors a prescription drug benefit and rely mainly on private insurers to administer the plan.

Hawaii Democratic Reps. Patsy Mink and Neil Abercrombie voted against the Republican-backed measure.