More than 1.7 million Medicare beneficiaries call Michigan home, and their community pharmacists strongly support new bipartisan legislation that would give them more convenient access to prescription drugs and discounted co-pays.
Since the 2006 start of the Medicare prescription drug benefit, Congress and Medicare officials have periodically made enhancements to improve the program or address unintended consequences.
Now is the time for such action.
For no good reason, Medicare seniors are currently restricted by insurance middlemen in where they can access discounted co-pays for medication. So patients face the unwelcome choice of paying more to stick with a pharmacist they know and trust, or to switch pharmacies.
This is particularly challenging in rural areas where patients may have to travel 20 miles or more to access discounted or “preferred” co-pays. Even in urban and suburban communities, longer distances can be a challenge for seniors without reliable transportation, especially in winter months.
Many Michigan-owned community pharmacies and other pharmacy providers are willing to accept the drug plans’ terms and conditions required of “preferred” pharmacies. But insurance companies still lock them out, and patient choice suffers.
Essentially, the middlemen, together with their designated “preferred” pharmacies, are denying patients a meaningful choice and limiting competition from rival pharmacies.
New bipartisan legislation would alleviate this problem by giving seniors in medically underserved areas a greater ability to obtain prescription drugs at discounted co-pays at their pharmacy of choice, while also allowing Michigan-owned, small business pharmacies a better chance to compete. H.R. 4577, the Ensuring Seniors Access to Local Pharmacies Act, was introduced by U.S. Reps. Morgan Griffith, R-Va., and Peter Welch, D-Vt., and now has 58 cosponsors. It would let more pharmacies offer “preferred” co-pays so long as those pharmacies are willing to accept the drug plan’s terms and conditions.
Leading consumer groups support H.R. 4577, including Consumers Union, Medicare Rights Center, National Grange and the National Rural Health Association. Moreover, federal Medicare officials support allowing any pharmacies willing to meet drug plans’ terms and conditions to serve as “preferred” pharmacies because it is "the best way to encourage price competition and lower costs” in the Medicare drug benefit.
Indeed, expanding seniors’ access to medication in this way can help them stick with their prescribed drugs and avoid more expensive and invasive health care services.
But currently federal legislation is needed in order for that to happen. Michigan pharmacists ask the state’s congressional delegation to cosponsor and support H.R. 4577. In particular, Reps. Fred Upton, John Dingell and Mike Rogers serve on the House Energy and Commerce Committee, which has substantial jurisdiction over the proposal. In addition, Rep. Dave Camp leads the House Ways and Means Committee, and Sen. Debbie Stabenow serves on the Senate Finance Committee. Both of those panels bear Medicare oversight responsibilities along with the Energy and Commerce Committee.
H.R. 4577 is a straightforward proposal to give seniors better access to medications and choice; to keep more health care dollars within the state at Michigan-owned pharmacies; and to let taxpayers enjoy the fruits of more robust competition in Medicare. We believe that is a prescription worth supporting and fighting for today.
Larry Wagenknecht is CEO of the Michigan Pharmacists Association, and Douglas Hoey is CEO of the National Community Pharmacists Association.