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July 21, 2005
Contact: Dan Lara, University Relations, (785) 864-8855.

KU research finds problems with federal prescription drug legislation


LAWRENCE -- University of Kansas researchers examining the medication needs of individuals with disabilities have uncovered possible serious consequences with the federal prescription drug legislation set to go into effect in January.

The team specifically looked at a subset of Kansans with disabilities under age 65 who are enrolled in Medicare and are eligible for Medicaid coverage because of their limited assets and income. The study focused on individuals enrolled in Kansas' Working Healthy program, one of 31 Medicaid "buy-in" programs nationally, designed to increase employment and independence among this population, who generally are younger and have different medical conditions than the majority of people served by Medicare. The issues identified in the study also will apply to a much broader population of people with disabilities.

They found that this population may face increased out-of-pocket expenses, decreased access to needed medications and other negative consequences when the new prescription drug plan created by Title I of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 goes into effect Jan. 1, 2006.

" The implication is that people with disabilities who are currently receiving Social Security disability benefits and are working may not be able to get their medications when their prescription coverage switches from Medicaid to Medicare," said the study's lead author, Jean P. Hall, assistant research professor at the KU Center for Research on Learning (KU-CRL), Division of Adult Studies. "The consequences may be that they will become sicker and unable to continue working."

Of the 40 million seniors and individuals with disabilities enrolled in Medicare nationwide, 2.4 million fall into this "dual-eligible" group.

" Because this is a relatively small population, most people and policy-makers don't know about their drug utilization characteristics and how this legislation may disproportionately have negative impacts for them," Hall said.

" Younger folks with disabilities have different medication needs from seniors," she said. "I truly believe that no one considered the broader consequences of this legislation on their work efforts and on work incentive programs created by other legislation."

Participation in the new prescription drug coverage plans is mandatory for dually eligible people with disabilities. The study found that because this population has substantially higher overall medication costs than other groups targeted by the prescription drug legislation, providers will have little incentive to enroll them in plans, their premium subsidies likely will not afford the coverage they need, and their increased need for brand-name medications in the absence of generic equivalents will mean higher out-of-pocket payments to control their medical conditions. Some of these individuals may find that as a result of this legislation, they would be better off financially to not work, which could erode the work incentives created by such programs as Working Healthy.

The report, "Unintended Consequences: The Potential Impact of Medicare Part D on Dual Eligibles with Disabilities in Medicaid Work Incentive Programs," by Hall; Janice M. Moore, project coordinator at KU-CRL; and Theresa I. Shireman, associate professor of pharmacy, is available on the Kaiser Family Foundation Web site, http://www.kff.org/medicaid/7330.cfm. The KU team received funding for the study from the foundation's Kaiser Commission on Medicaid and the Uninsured.

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