The Make Medicare Work Coalitions Policy Activities

1
The Make Medicare Work Coalitions Policy
Activities

• June 2008

2
MMW Policy Goals for 2008 and 2009

• Expansion of Illinois Cares Rx and Medicare
  Savings Programs
• More efficient and effective enrollment and
  re-enrollment procedures for Illinois Cares Rx
• Assure Illinois Medicare beneficiaries are
  represented in national discussion on improving
  Medicare Part D.

3
The State Bills

• HB 4449
• HB 4574
• HB 5521
• Medicare Savings Program Expansion

4
HB 4449 (Franks, Halverson)

• Income level of Illinois Cares Rx set at 250 of
  Federal Poverty Level.
• All Medicare beneficiaries receiving Illinois
  Cares Rx cost sharing with all prescriptions on
  their Part D coordinating plan
• ADAP drugs retain same cost sharing
• Status Unanimous Passage in House and
  Overwhelming Majority for Passage in Senate.
  Status on concurrence unknown.

5
HB 4574 (Feigenholtz)

• Codifies current Supreme Court case that
  disallowed certain estate recovery from spouses
  estate
• Will study current estate recovery practices,
  including what types of recovery occur, how they
  track expenses for recovery how much the state
  collects, and which programs utilize estate
  recovery
• Study will result in better targeted or
  incremental approach to reducing estate recovery
  that result in decisions not to access needed
  programs
• Status Did not move in the Senate

6
HB 5251 (Nekritz)

• Expands Health Benefits for Workers with
  Disabilities (HBWD) to include medically
  improved.
• Allows former Medicare beneficiaries to keep
  comprehensive health care through HBWD.
• Status Unanimous Passage in House and Senate.
  Status of concurrence unkown.

7
Medicare Savings Program Expansion

• Expand Medicare Savings Programs through income
  disregards to make more individual extra help
  eligible.
• Original fiscal note too high to make sense.
• Will continue discussions on expansion to see how
  a targeted approach could save state money and
  provide better coverage.

8
Overall Impact

• Settled Illinois Cares Rx eligibility at higher
  income level and comprehensiv coverage.
• Allow Medicare beneficiaries who work and
  medically improve to maintain healthcare
  coverage.
• Encourage further enrollment in Medicare Savings
  Programs through better understanding of estate
  recovery.
• Possibly increase pool of enrollees for Medicare
  Savings Programs while saving Illinois Cares Rx
  dollars

9
What is Going On?

• Long running feud between House and Governor over
  rulemaking, which began last year.
• House adds Amendment 1 to most bills (especially
  healthcare).
• Senate strips Amendment 1 from the bills.
• No resolution before adjournment.

10
What Can Coalition Participants Do?

• All along, phone calls, letters and faxes have
  helped to move these bills along, particularly HB
  4449.
• Important that leadership continue to hear from
  Coalition participants about the importance of
  these bills.
• If agreement is reached, we want these bills
  identified as a priority.

11
Federal Advocacy--Congress

• House passed CHAMP Act to improve Medicare Part
  D, but Medicare provisions stripped in Senate
  version
• Senate Finance Committee set to consider Medicare
  bill this month.
• Senate Democrats will introduce bill
  (bi-partisan?) Friday and Senate Republicans are
  expected to introduce bill as well.

12
What Will These Bills Do?

• Main difference between Democrat and Republican
  bill beneficiary protections and cuts to
  Medicare Advantage plans.
• Both focus on physician payment cuts.
• Democrat bill still in flux beneficiary
  protections changing every day.
• Cloture vote schedule week of June 16.

13
Medicare Prescription Drug Savings and Choice Act
(HR 3932 and S 2219)

• Sponsored by Rep. Berry, Rep. Schakowsky, Senator
  Durbin and Senator Obama
• Creates one or more Medicare-sponsored drug plan
  that will compete with PDPs
• Would negotiate drug prices and create an appeals
  process

14
Off-Label Use Legislation

• Part D has strict off-label use rules
• MRC has been gathering stories and evidence about
  the negative impact
• Must be fixed by legislation
• Emerging issue

15
Other Federal Advocacy

• 1-800 Medicare Advocacysurvey in the fall.
• Better coordination between state and federal on
  communications to consumers (emphasis Federal).
• Other Issues?