Stateline Story

State Officials Challenge Rx Study

Headlines in major newspapers across the country last week revealed grim news about state Medicaid programs.

"One in Four Medicaid Beneficiaries Unable to Fill Prescriptions," papers reported.

But some state officials question the claim.

The stories were based on an April 9 study by the Center for Studying Health System Change , a nonpartisan policy research group backed by the Robert Wood Johnson Foundation.

The center regularly surveys nearly 60,000 people in 60 communities on hospital care and finances, doctors, HMOs and other health insurance plans. The prescription drug study was based on interviews with 39,000 adults ages 18 to 64.

Of that number, 1,800 people said they were in Medicaid or a category the center labels "other state coverage."

The small sample size concerns health policy experts. "I'm not saying Medicaid is perfect, but I question the accuracy of the results," says Joan Henneberry of the National Governors Association (NGA) .

Maine Human Services Commissioner Kevin Concannon, who oversees his state's Medicaid program and has been working for years to cut back on prescription drug costs, also challenges the study. He says based on the numbers, the center only surveyed one or two people in Maine.

"We wonder about the validity of the study (given the numbers and) that it's applied as a whole to the country," he says.

Concannon says the study results don't reflect Maine's program. "We increased by 600,000 last year the number of prescriptions paid for by Medicaid, for a total of 4 million prescriptions. I don't see any evidence of access problems," he says.

On top of that, the state's Healthy Maine Prescriptions Program , an expansion of Medicaid, covered another million prescriptions last year.

Policy experts also questioned the survey's link between states which have put multiple cost-cutting measures in place and people saying they couldn't afford drugs.

Under federal law, Medicaid enrollees don't have to pay co-pays , and a sliding fee scale that goes from 50 cents up to $3 per prescription has been in place for 20 years, says Ray Hanley, Arkansas' Medicaid director.

"The majority of Medicaid patients are totally exempt even from nominal co-payments. And if the patient says, I don't have $1,' the pharmacist has to dispense the drug anyway," he says.

Hanley, who has served as his state's Medicaid director for 16 years, says he's yet to hear people on Medicaid say they can't afford to pay for prescription drugs. "I'm not sure what drug the researchers were on (when they did this study), but they're clearly not familiar with these programs," he says.