prescription drug bill
The law is a break for people
who earn too much for Medicaid
Gov. Linda Lingle signed into law yesterday legislation designed to lower prescription drug costs for an estimated 300,000 Hawaii residents without drug coverage.
Senate Bill 3237, HD1, establishes the Hawaii Rx Plus Program, which will offer discounted drug prices to people who do not have prescription drug insurance coverage or have exceeded their prescription drug benefits and earn too much money to qualify for Medicaid.
Residents who earn less than 3 1/2 times the federal poverty level qualify for Hawaii Rx Plus.
Lawmakers had to bulletproof the program this year after the U.S. Supreme Court reviewed Maine's law, the model for Hawaii's program, raising some legal concerns. One of them was to set a qualification cap on participants.
For a single person the income limit is $37,000, while the income limit for a family of four is $76,000, said Lillian Koller, state human services director, whose department will administer the program.
"And these people, they're not so low-income that they're eligible for Medicaid, so they have either too much assets or income for Medicaid, but they are struggling to pay their drug bills," Koller said.
Two people who hope to qualify for Hawaii Rx Plus are Ruby Silva, 72, and her husband, Gilbert, 73, both retired and living on fixed incomes.
Two months ago the Silvas were paying $650 a month for prescription drugs. Most of the drugs are for Gilbert, who has congestive heart failure, diabetes, high blood pressure and high cholesterol.
Their monthly drug bill is now up to $680.
"That's a great relief," Ruby Silva said. "I was a little apprehensive because of the situation with the state budget."
The law comes with a $400,000 appropriation to get the program started.
In the first year of the program starting July 1, qualified residents will be able to purchase prescription drugs at Medicaid prices through participating pharmacies. The savings are expected to be about 15 percent.
"The primary purpose of the rollout starting July 1 is to get as many of those 300,000 people enrolled," Koller said.
Silva said the first-year discount will hopefully keep her drug bills in check.
Then on July 1, 2005, the state will be able to offer additional discounts based on state-negotiated rebates from drug manufacturers.
State lawmakers approved legislation for a Hawaii Rx Program two years ago but delayed the start pending the outcome of a legal challenge to the Maine prescription drug program.
Lingle initially opposed Hawaii Rx but said last year that she would support it if lawmakers made changes to the law to prevent legal challenges.
Hawaii Rx Plus
>> People whose household income is equal to or less than 350 percent of the federal poverty level ($37,000 for a single person, $76,000 for a family of four) and who lack prescription drug coverage or have exceeded their prescription drug benefits.
Effective july 1
>> Participants can purchase prescription drugs at Medicaid prices from participating pharmacies.