Copyright 2001 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch
August 29, 2001 Wednesday Five Star Lift Edition
SECTION: EDITORIAL; Pg. B6

LENGTH: 437 words

HEADLINE: DOING MORE WITH LESS

BODY:
PRESCRIPTION DRUGS

LAST FALL, during the election, just about everybody was for helping seniors with the costs of prescription drugs. But this fall, there's no money left.

The federal budget surplus has disappeared, and Missouri is hacking programs to make ends meet. That is the context in which Gov. Bob Holden is bringing the Legislature back into special session next week to enact a prescription drug plan.

For the past two months, a parade of witnesses has appeared before Mr. Holden's prescription drug task force to relate their daily struggles paying for costly medications. Today, the task force will unveil its solution -- a safety net program to help low-income seniors with catastrophic expenses.

Its recommendation stands in sharp contrast to the state's existing drug assistance program. That ill-conceived plan provided an inadequate $200 tax credit to state residents over the age of 65. It cost about $87 million annually, more than four times what had been anticipated.

This time, legislators have just $50 million to bankroll a new prescription plan. That may sound like a lot. But in the world of health care, it's a drop in the bucket. Competing prescription drug plans approved in the state Senate and House earlier this year carried expected price tags of $70 million and $117 million, respectively.

Instead of aiding all senior citizens, the task force focused on helping low-income residents with very high prescription drug expenses. The poorest elderly state residents -- couples earning less than $842 a month -- already qualify for prescription drug coverage under Medicaid. Task force members are expected to recommend that income guidelines for Medicaid prescription drug coverage be relaxed slightly. Even then, most seniors won't qualify. It is people who earn just above the Medicaid eligibility level who would benefit from the proposal.

Substantial questions will remain when the Legislature convenes. Prescription drug spending has increased an average of about 10 percent annually over the past decade. In addition, the number of people over age 65 will rise sharply in coming years, so paying for the program in future years could be challenging.

But the high cost of prescription drugs threatens to bankrupt many of the state's vulnerable elderly residents. Meanwhile, the vanishing federal surplus will make creating a Medicare prescription drug benefit difficult.

Missouri's attempt to maintain fiscal discipline while aiding the elderly seems like the right prescription. But it is a far cry from last fall's broad election promises.

LOAD-DATE: August 29, 2001