Assistance plan has support

    Rhode Island has more than 208,000 people, or upward of 20 percent of its population, age 60 and older. The National Family Caregiver Association notes there are 76,000 Rhode Islanders between the ages of 21 and 64 who have at least one disability that affects their ability to perform the daily tasks of living. Also, the association estimates that there are 117,000 unpaid caregivers in Rhode Island, and AARP reports that more than 11,000 children in Rhode Island are living in 5,000 households headed by grandparents.
    Rhode Island devotes more than $3.1 billion dollars, or 40 percent of the state budget, to human service programs. This year’s proposed budget for the state Department of Elderly Affairs (DEA) calls for level funding of community-based services such as home and  adult day care, elder protective measures and housing security. The area of funding drawing the most attention is the Rhode Island Pharmaceutical Assistance to the Elderly (RIPAE) program.
    Since 1985, RIPAE has helped thousands of seniors pay for a portion of prescription medications that are essential to maintaining good health. When Medicare prescription drug (Medicare Part D) plans became part of the health care landscape in 2006, some states discontinued their pharmaceutical assistance programs. Rhode Island elected to continue RIPAE, with adjustments to coordinate state benefits more effectively with the benefits of Part D insurance plans.
    With the implementation of the Patients Protection and Affordable Care Act (PPACA), DEA is faced once again with the prospect of change in the RIPAE program. This year, Medicare Part D plans will pay for 50 percent of brand name medications and 7 percent of generic medications when a beneficiary enters the doughnut hole or coverage gap of his or her Part D plan. The doughnut hole will be narrowed gradually over the next nine years.
    In response to those changes, Gov. Lincoln Chafee has included “Next Generation RIPAE” in his 2012 proposed budget. The Advisory Commission on Aging supports the development of an updated and cost-efficient state pharmacy assistance program for several reasons:
    • Medicare beneficiaries with limited income and resources are eligible to be enrolled in the low-income subsidy (LIS) program for Medicare Part D plans. LIS members have no plan premium, deductible or co-payments and do not enter the doughnut hole. They pay no more than $2.50 for a generic prescription and no more than $6.30 for a brand name drug. They do not need RIPAE.
    • Part D is reducing prescription drug costs for Rhode Island Medicare beneficiaries. Of the 181,000 beneficiaries in the state, 122,000 are covered by Part D stand-alone plans or coverage through a Medicare Advantage plan, which includes Part D prescription coverage. More than 12,000 persons receive coverage through employee benefit programs and 25,000 have other forms of prescription drug insurance.
    • Continuation of RIPAE benefits as they now exist would mean very costly technical changes in claims processing that would consume a substantial part of any RIPAE allocation that would ordinarily go to benefits for seniors.
    • Continuation of full RIPAE funding would adversely impact other support programs such as home care.
    It is important to note that DEA is not abandoning its RIPAE members during the transition to “Next Generation RIPAE.” DEA, in cooperation with the POINT’s regional agencies, is proactively identifying high users of RIPAE benefits and those who may fall into the doughnut hole before June 30. The goal is to assist these members and to assure that they are in the most effective Part D plan for their prescription needs.

    Rick Ryan is chairman of the Rhode Island Governor’s Advisory Commission on Aging. Contact him at 401.364.0690 or ryan.spritely.richard@gmail.com.