More than 20 years ago, older Mainers began crusading against high prescription drug prices.
Credit: George Danby / BDN

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Beth Beausang is health care adviser to Maine Gov. Janet Mills and worked previously for U.S. Rep. Chellie Pingree. Mark Sullivan is a retired communications professional who worked in state and federal offices and for public interest groups. Both served as staff to former Maine U.S. Rep. Tom Allen.

On a rainy summer morning in 1999, a group of older Mainers boarded a chartered bus in Portland, headed for Quebec on an unusual shopping trip. At a Montreal drug store, they purchased essential prescriptions for a fraction of what they cost in Maine. This was not the first, nor would it be the last such expedition. But on this trip Mike Wallace and a “60 Minutes” news crew came along to cover it.

Activism by older Mainers, beginning a quarter century ago, blazed the trail for key health care provisions in President Joe Biden’s Inflation Reduction Act that expand coverage and affordability for millions of Americans, including tens of thousands of Mainers.

The new law extends assistance for lower insurance premiums to about 59,000 Mainers covered through the Affordable Care Act and sets a cap on out-of-pocket prescription drug expenditures for Medicare beneficiaries at $2,000 per year. The new law also allows Medicare to negotiate lower prices for prescription medications, a cost-cutting measure those bus-riders advocated for.

Historically, pharmaceutical manufacturers have negotiated lower prices with big customers that buy in bulk — insurance companies, managed care organizations, state Medicaid programs and even certain federal agencies like the Veterans Administration. For decades, PhRMA, the drug companies’ powerful lobby, has spent hundreds of millions from their billions in profits, to block their biggest customer, Medicare, from price negotiation.

In February 1998, at a Sanford constituent forum, retired firefighter Leon Currier urged first-term U.S. Rep. Tom Allen to focus on soaring drug prices. Currier’s doctor had prescribed a medication so expensive he had decided not to take it. The next day, Allen directed his staff to investigate options and recommend actions to provide relief to Currier and millions of older Americans struggling to pay for needed medications, which was not then a priority for Congress.

A member of the House Committee on Government Reform, Allen asked committee staff to conduct a study comparing over-the-counter prices older Mainers in his district paid for their drugs with those pharmaceutical companies negotiated with “favored customers.” Released in 1998, the study found that older Mainers paid, on average, more than twice as much for their medications. Subsequently, House members from all over the nation commissioned studies based on the Allen model with similar results. Further studies also compared prices uninsured Mainers paid for medications to those in Canada and Mexico, confirming that prices in both were a fraction of what Mainers paid.

On Sept. 28, 1998, Allen introduced the Prescription Drug Fairness for Seniors Act, the first legislation to empower Medicare to negotiate lower prescription drug prices for Medicare recipients. Massachusetts U.S. Sen. Ted Kennedy subsequently introduced the bill in the Senate. Republican House leaders refused to hold hearings or allow a vote on the bill. Allen reintroduced the bill in subsequent congresses, eventually enlisting 153 co-sponsors.

Meanwhile, older Mainers continued to share their prescription cost concerns with Allen and other federal and state legislators. Viola “Vi” Quirion, a retired factory worker in Waterville, spent a quarter of her $900 per month income on her medications. She was a passenger on that 1999 bus trip and shared her story with “60 Minutes” viewers nationwide. Despite significant health challenges, Quirion became a dedicated activist.

John Marvin, regional director of the National Council of Senior Citizens, organized that bus trip. He later worked with Chellie Pingree, then a state senator from Knox County, on Maine Rx, state-level price negotiation legislation. PhRMA challenged that legislation all the way to the U.S. Supreme Court, which ultimately ruled in Maine’s favor. Grateful older Mainers dedicated a wing of an Augusta senior living residence in Marvin’s memory.

PhRMA also blocked price negotiation from the 2006 legislation establishing Medicare Part D prescription drug insurance and the 2010 Affordable Care Act. The Inflation Reduction Act, supported by Maine U.S. Reps. Pingree and Jared Golden and U.S. Sen. Angus King, finally overcame PhRMA’s crusade against price negotiation.

Let us celebrate the older Mainers who helped pave the way to this historic achievement. And may we continue to follow their example to expand coverage and reduce health care costs for all Americans.