Wednesday, March 5, 2014

It Just Doesn’t Make a Whole lot of Common Sense

Tennessee Congresswoman Marsha Blackburn, Vice Chair of the House Energy and Commerce Committee at the February 26th meeting about the proposed Medicaid Part D changes said, “It just doesn’t make a whole lot of common sense, Mr. Blum,” in response to Blum’s statements about the proposal.  During her five minutes of questioning, Blackburn spent the majority of the time bashing the new plan for Medicaid Part D.  To her, it did not make sense to alter a program that 95% of beneficiaries approved of, especially when the change would limit options and is projected to raise costs.  Currently, only 12% of the Medicaid budget is spent on Part D.  Mr. Blum is the principle administrative director of CFS and was the first panelist at the meeting; he was questioned for over two hours.

Blum claimed that although Part D has been extremely successful and has a high approval rating, there are still some “vulnerabilities” that need to be redressed.  According to him, the proposed changes will alleviate some of the main issues with the current program.  In Blum’s opinion, it will decrease prescriber fraud, help simplify the plan options (by decreasing from over thirty plans to less than four), make the plans less complex, and reduce taxpayer cost.  The new regulation will require more paperwork to be done by prescribers, and give beneficiaries a significantly smaller amount of plan options.

Even though the cost for the program has decreased over the past few years and there are extremely high approval rates, the Obama administration feels a need to adjust Medicaid Part D.  Consequently, it is extremely likely that the cost for beneficiaries will increase while the amount of care/treatment received they need will decrease.   Blackburn was on to something: there really isn’t much logic with this proposal.  Why fix something already regulated that is not working with new regulations?  Adding additional regulations that will make life harder and put more work on the physicians is not the solution, but rather, they should improve the regulations already in place.  Why drastically alter a program that has extremely high approval rating? Very few governmental programs have only five percent dissatisfaction rate. Phrases were thrown out such as “if its not broke, don’t fix it,” and it’s okay to hit the tire even if working, but not when your foot comes back and it hits you.

The overwhelming success of Medicaid Part D along with the high satisfaction does not mean that we should not look at it to fix some of the issues that many seniors are unaware of, but this proposal is not the answer.  As the Congresswoman from North Carolina, my home state, pointed out, 7.4 million out of 7.9 of the state’s seniors will be effected by the change, a change that they do not want.  The majority of the 7.4 million in my home state will be effected negatively.  One of the biggest drawbacks of the plan is that there will be fewer options.  Although having a vast amount of choices can be confusing for seniors at times, choice in plans provides more positives than negatives.  The proposal practically gives no choice to the beneficiaries.

Not only are there logical issues present with the Medicaid Part D proposal, but legal as well.  Almost every congressman pointed out that it would violate the Noninterference Clause, which restricts government from negotiating between private parties.  Under the proposal, the CRS would be able to communicate and negotiate with manufacturers and pharmacies, which they justified under their “new interpretation” of clause.  As expected this received scrutiny from many of the congressmen present.

Not one of the committee members present was in favor of the proposal.  And it makes sense.  The hearing brought up points that made it appear that the new proposal would not help, but actually hurt beneficiaries and physicians, especially those in rural areas. Congresswoman Blackburn hit the nail on the head: this proposal doesn't make the least bit of common sense.

-Brittany Levine
National Grange Intern

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