In a year when Maine is not facing a budget crisis — and with clear bipartisan support for policies that support building an age-friendly Maine — it is troubling that programs that help people stay safely at home are in jeopardy. Maine should lead in taking care of its oldest and poorest residents.
We are halfway through the legislative session, and many of Maine’s seniors are wondering whether they will be able to afford their health care costs and much-needed prescription drugs. While it is understandable that balancing a state budget presents unique challenges, there is an element in the current budget proposal that is of particular concern to seniors and disabled Mainers on low or fixed incomes. These Mainers are grappling, as they do each year, with the challenge of simply getting by from one month to another. Faced with often crushing everyday costs of buying food, heating their homes and other living expenses, some are in great despair. For them, the proposed cuts to the Medicare Savings Program and the Drugs for the Elderly Program will be nothing short of devastating. Sadly, many of our leaders do not understand the depth of the impact.
The Medicare Savings Program, or MSP, covers Medicare Part B premiums that pay for doctor visits, preventive care, ambulance services and outpatient care. It also covers Medicare Part D prescription drug costs and co-payments. Under the current proposal, tens of thousands of seniors will be cut from the program. Depending on their circumstances, these at-risk Mainers will lose some or all coverage for these services.
The Drugs for the Elderly Program, or DEL, helps pay for prescription drugs for Mainers whose monthly income falls below approximately $1,600 for an individual and $2,200 for a couple. It is important to remember that this income has to cover housing and heating costs, food and other necessities. Current DEL beneficiaries are on the cusp of Medicare eligibility — between the ages of 62 and 64½. They are counting the days to Medicare eligibility and are among the state’s poorest.
Some argue that these individuals can get prescription drugs cheaply at hospitals, pharmacy chains or through pharmaceutical companies. It just isn’t that simple.
Currently, these individuals have an integrated way to access the health and prescription drugs they need. The alternative is asking our oldest and most vulnerable to “shop around” to piece together what they need. Many of the drugs older people take to manage chronic diseases do not have a generic alternative. Still other drugs are not offered as part of the low-cost formulary. Additionally, many patients are required to take a brand-name drug instead of the generic because their doctor determines that it is “medically necessary.” While some consumers might be successful in applying for a limited supply through a pharmaceutical company, the application is arduous, especially if one is older and already sick. Many of the programs offered by pharmacies are meant for people without insurance, so Mainers on Medicare don’t qualify. Such so-called solutions are not viable.
At committee hearings in March, older Mainers shared their dismay at the proposed cuts. Some were clearly in physical and emotional distress as they delivered their testimony. We must listen to them.
If these cuts are approved, close to 21,000 low-income seniors and Mainers with disabilities will see their health care costs rise by at least $200 per month. That’s the best-case scenario. Approximately 12,000 people will lose their MSP eligibility altogether. This means that, at a minimum, they will have to begin payment of their Medicare Part B premium, which will cost them an additional $1,260 per year. Since those receiving MSP are automatically eligible for the Medicare Part D prescription drug Low Income Subsidy, or LIS, program, most of these Mainers will lose MSP and the LIS.
Nearly 1,800 Mainers who use the DEL program to help pay for their prescriptions will lose all help. These cuts will impact people’s lives. It’s also economically foolish, as these programs help people stay in their own homes and communities.
AARP Maine is urging lawmakers to reject any budget proposal that harms our most vulnerable residents. Those affected by these budget cuts are our parents, grandparents, and our neighbors. You can make your voice heard by contacting your legislators at 800-301-3178.
Lori Parham is state director of AARP Maine.