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"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," Blagojevich said. "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. We can't let seniors fall through the cracks, and No
Senior Left Behind makes certain that will not happen." Effective
Jan. 1, 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, 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 Prescription" 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," said Sen. Carol Ronen,
D-Chicago, the bill's Senate sponsor. "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."
"This measure will fill the gaps in the federal Medicare
prescription drug benefits," said Rep. Barbara Flynn Currie,
D-Chicago, the bill's sponsor in the House. "The governor's
signature on Senate Bill 973 ensures that no low-income senior or
disabled Illinoisan will be left behind."
"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," said U.S. Rep.
Rahm Emanuel, D-Ill.. "This is a waste of taxpayers' money and a raw
deal for seniors. 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 premium of $35 per month. Beneficiaries
are responsible for all of their costs between $2,250 and $5,100,
with the plan paying 95 percent of costs beyond the top threshold.
The gap between $2,250 and $5,100, where a beneficiary has to pay
all the drug costs, is commonly referred to as the "doughnut hole."
The new "wraparound coverage" provided by this law to Illinois
seniors and people with disabilities will help cover the increased
costs of the Medicare program, including premium costs, coinsurance,
coverage within the "doughnut" and the deductible. For example, a
senior whose income is 160 percent of the federal poverty level
(around $19,900 for a family of two) 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 $1,800 worth of drug spending
would spend $120 on average in the new Illinois program but over
$1,000 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.
The bill passed out of the House of Representatives by a vote of
115-1 and passed the Senate unanimously.
Illinois Cares Prescription will be administered by the
Department of Healthcare and Family Services (formerly the Illinois
Department of Public Aid) and the Department on Aging.
Also included in Senate Bill 973 is an expansion of the Illinois
Prescription 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 Prescription Buying Club and the I-SavePrescription
drug importation program.
[to top of second column in this article]
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 The announcement Wednesday is part of
Gov. 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 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 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 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 that are either kicking people off Medicaid or
significantly reducing benefits.
First state to develop a statewide small-business health
insurance pool and program: 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 percent to 15 percent and provide more health care for
their employees. Illinois will be the first state to create a pool
that businesses of 50 employees or fewer can join, saving money on
the negotiated rate, administrative costs and broker fees.
- First state to make prescription drugs from Europe and Canada
available:
Under 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 percent to 50
percent less) for over 120 name-brand prescription drugs.
- First state to require pharmacists to dispense female
contraceptives:
In April, 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 per year on the cost of
their contraceptives.
- Improving women's health programs:
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 Blagojevich took office.
- Accessing nearly $2 billion in new federal health care money:
This summer, Blagojevich will sign the hospital assessment
legislation, which if approved by federal Centers for Medicare and
Medicaid Services, will bring nearly $2 billion in new federal
funding for Illinois hospitals over the next three 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, 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. 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, 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.
[News release from the governor's
office] |
