CHICAGO – Governor Rod R. Blagojevich today signed the ‘No Senior Left Behind’ law – critical legislation that protects Illinois seniors from the shortfalls created by the federal prescription drug program. In January of 2006, Medicare begins its new prescription drug benefit program and it is expected to increase out-of-pocket drug costs for seniors. The Governor’s bill provides a safety net to seniors from those increasing costs. This new law is the nation’s most comprehensive state response to fill in the gaps created by the federal Rx drug program.
“Hundreds of thousands of Illinois’ seniors and persons with disabilities rely on our network of prescription drug programs to help afford the medicines they need. When Medicare drug benefits come on line in January, seniors in many other states will see their out-of-pocket costs for prescription drug go up. But, not here in Illinois,” said Gov. Blagojevich. “We can’t let seniors fall through the cracks and ‘No Senior Left Behind’ makes certain that will not happen.”
Effective January 1st, 2006, the same day Medicare prescription benefits come into effect, the new law helps those in need cover costs that are not included under the new federal program. This new program will cover those who were previously enrolled in either the SeniorCare drug program or the Circuit Breaker pharmaceutical assistance program. By signing this law, Governor Blagojevich ensures that both groups are guaranteed the same coverage they previously received. In addition, those who are not eligible for Medicare will have their current SeniorCare or Circuit Breaker pharmaceutical benefits maintained in the new program, which by popular demand of seniors was named the “Illinois Cares Rx” program.
Illinois’ approach contrasts starkly with the methods taken by several other states such as Michigan and North Carolina. Both states are eliminating their state prescription drug programs and transferring people completely to the Medicare drug program, which will significantly increase their out-of-pocket expenses.
"This new law will ensure that seniors in Illinois will have access to the prescription drugs they need. I am proud that Illinois is once again leading the nation in providing health care access to its citizens, I applaud the governor for his leadership on this issue,” said Sen. Carol Ronen, the bill’s Senate sponsor.
“This measure will fill the gaps in the federal Medicare prescription drug benefits. The governor’s signature on Senate Bill 973 ensures that no low income senior or disabled Illinoisan will be left behind,” said Rep. Barbara Flynn Currie, the bill’s sponsor in the House.
"The Medicare drug benefit that will go into effect next year missed three opportunities to bring down the cost of prescription drugs - it prohibits the importation of affordable prescription drugs from Canada and Europe, forbids the HHS Secretary from negotiating with drug companies for lower prices, and it doesn't do enough to help cheaper generic drugs get to market faster. This is a waste of taxpayers' money, and a raw deal for seniors," said Rahm Emanuel (D-IL). "Governor Blagojevich continues to be a leader in reducing the costs of prescriptions drugs for Illinoisans without placing new burdens on our seniors. I applaud him for giving Illinois seniors the peace of mind that they will not get with the Medicare drug benefit alone."
The federal Medicare Modernization Act helps seniors by paying 75 percent of prescription drug costs up to $2,250 after a $250 deductible with an average $35 per month premium. Beneficiaries are responsible for all of their costs between $2,250 and $5,100, with the plan paying 95 percent of costs beyond that top threshold. The gap where a beneficiary has to pay all the drug costs between $2,250 and $5,100 is commonly referred to as the “donut hole.”
The new “wrap around coverage” provided to Illinois seniors and persons with disabilities by this law will help cover the increased costs of the Medicare program, including premium costs, coinsurance, coverage during the “donut,” and the deductible. For example, a senior whose income is 160 percent of the federal poverty level (around $19,900 for a family of 2) who has annual drug costs of $5,100 would have to spend over $4,000 in out of pocket costs if the new Illinois program did not exist, but less than $1,000 with the new Illinois program. A senior who has $1800 worth of drug spending would spend $120 on average in the new Illinois program but over $1000 in Medicare if they did not receive assistance.
As many as one-quarter of the 20.3 million seniors in the United States who will be using the federal benefits without low-income assistance are expected to have drug costs high enough to bump them into that coverage gap.
Senator Carol Ronen (D-Chicago) and State Representative Barbara Flynn Currie (D-Chicago) sponsored the legislation. The bill passed out of the House of Representatives by a vote of 115-1, and passed the Senate unanimously.
Illinois Cares Rx will be administered by the Department of Healthcare and Family Services (formerly IL Department of Public Aid) and the Department on Aging.
Also included in SB973 is an expansion of the Illinois Rx Buying Club to Illinoisans who are uninsured and whose income is less than 300 percent of the Federal Poverty Level. These uninsured Illinoisans often pay the highest price for their prescriptions. This law will allow them to have access to discounted prices as negotiated by the state.
Under the Blagojevich administration, Illinoisans benefit from a wide array of programs designed to assist them with the high cost of prescription drugs: SeniorCare, Circuit Breaker (the pharmaceutical assistance program), the Rx Buying Club and the I-SaveRx drug importation program.
Today’s announcement is part of Governor Blagojevich’s long standing effort to make sure that more people get more health care and better benefits, protect coverage for those who have health care, and help hospitals, doctors and nurses provide better health care. Specifically:
· Best in the nation for providing health care to the working poor: Since Governor Blagojevich took office, 313,000 more men, women and children have received health care through the KidCare and FamilyCare programs – at a time when most states are not only not providing more coverage for the working poor, but also kicking people off of Medicaid or significantly reducing their benefits. This year’s budget included funding to add another 56,000 parents. The Kaiser Foundation has ranked Illinois the best state in the nation for providing health care to people who need it.
· One of only a handful of states to protect Medicaid recipients: The budget signed by Governor Blagojevich a few weeks ago ensures – for the third consecutive year, despite facing budget deficits – that Medicaid recipients maintain their health care, unlike states ranging from Missouri to Tennessee to Texas to Washington who are either kicking people off of Medicaid or significantly reducing benefits.
· First state to develop a statewide small business health insurance pool and program: Governor Blagojevich and the Chicagoland Chamber of Commerce are developing a small business health insurance program that will help small businesses reduce their costs by 10-15% and provide more health care for their employees. Illinois will be the first state to create a pool where businesses of 50 employees or less can join, saving money on the negotiated rate, administrative costs and broker fees.
· First state to make Rx drugs from Europe and Canada available: Under Governor Blagojevich, Illinois became the first state to allow its citizens to purchase prescription drugs from Europe and Canada. Nearly 10,000 people have enrolled in the last few months alone to take advantage of lower prices (25-50% less) for over 120 name brand prescription drugs.
· First state to require pharmacists to dispense female contraceptives: In April, Governor Blagojevich issued an emergency rule requiring pharmacists whose pharmacies sell contraception to dispense birth control to women with valid prescriptions. The Governor’s emergency rule will become permanent this summer. In addition, the state will soon launch a new website to help women know which insurers now cover contraceptives, helping hundreds of thousands of women save an average of $400/ year on the cost of their contraceptives.
· Improving women’s health programs: Governor Blagojevich created the Illinois Healthy Women program to provide health care to women who otherwise would go without. To date, the program has served more than 90,000 women. In addition, Illinois has dramatically increased the number of mammograms and cervical cancer screenings since Governor Blagojevich took office.
· Accessing nearly $2 billion in new federal health care money: This summer, Governor Blagojevich will sign the hospital assessment legislation, which if approved by federal CMS will bring nearly $2 billion in new federal funding for Illinois hospitals over the next 3 years. Last year, the Governor persuaded the U.S. Department of Health and Human Services to approve a plan that meant nearly $500 million in new federal funds for Illinois hospitals.
· Medical Malpractice Reform: This summer, Governor Blagojevich will sign major medical malpractice reform legislation, which will reduce the cost of insurance premiums for doctors and stop doctors from leaving the state. Governor Blagojevich helped pass the legislation despite his personal opposition to caps, because making sure that people have access to health care is probably the most important function government performs.
· Reducing the nursing shortage: This summer, Governor Blagojevich will sign a package of bills aimed at reducing the nursing shortage in Illinois, including making it easier for foreign nurses to practice in Illinois. The state also eliminated the nurses registration backlog this April and increased the amount available in grants for nurses training. This fulfills the initiative launched by the Governor in his State of the State address to reduce the nursing shortage.
Seniors who want to find out more about the “No Senior Left Behind” law should call the Illinois Department on Aging Senior Help Line at 1-800-252-8966 or the Senior Health Insurance Program at 1-800-548-9034.