Governor Paterson’s 2009-2010 Executive Budget proposal contains a mixed bag for older New Yorkers. With continued support of home and community-based care services and new initiatives to reform prescription drug marketing - such as banning gifts to doctors - some of the Governor’s proposals make good financial sense and will improve health care access and quality. However, many services that support the independence and well-being of older New Yorkers were not spared from budget cuts, particularly, the state’s pharmaceutical assistance, Medicaid, and assisted living programs.
Proposed changes to the EPIC program would fundamentally dismantle one of the most comprehensive and successful programs of its kind in the country. EPIC “wrap-around” will no longer cover the cost of drugs for which no payment or reimbursement is made by Medicare Part D (however, EPIC will continue to cover the donut hole). The additional requirement that all EPIC recipients join Medicare Part D coverage plans regardless of whether it would be a financial “hardship”, would greatly limit an EPIC enrollee’s ability to access affordable prescription drugs. The result could be worsening health and great public expense as these individuals end up in emergency rooms and hospitals.
The proposed Executive Budget further erodes the impact of the New York Assisted Living Reform Act of 2004. This landmark legislation created consumer protection disclosures and ensured that older persons could safely age in place. The Executive Budget proposes creating thousands of new assisted living spaces that would be exempt from this law resulting in the creation of two types of assisted living in New York – one for the ‘haves” and the other for the “have-nots.” New York State should not have two sets of rules for assisted living - especially when the rules applying to the poor have lesser standards and benefits than those applying to people of higher incomes. New York doesn’t have different standards and protections for residents of nursing homes depending on whether they are paying the bill themselves or are receiving Medicaid assistance. So why should the state have different ones for assisted living?
Medicaid cuts to institutions and home care as proposed by the Executive Budget should be scrutinized very closely to determine their impact on the ability of nursing homes and home care agencies to deliver quality services. AARP believes that the care of vulnerable people should not be jeopardized by budget cuts in any manner.
Home and Community-Based Care Services
Many of the services that older New Yorkers rely on to stay in their communities as they age remained intact in the governor’s proposed budget. This was a prudent decision by Governor Paterson. Investing in existing programs such the Supplemental Nutritional Assistance Program (SNAP), the Expanded In-Home Services for the Elderly Program (EISEP), and Adult Day Care keeps people out of high-cost institutional care and allows them to age at home with independence and dignity.
Rx Market Reform
AARP applauds the Governor for including a ban on pharmaceutical gifts to doctors in his budget proposal. Banning gifts from drug companies to doctors and requiring doctors to publicly disclose any financial relationship with drug companies when conducting seminars could lead to more independent prescribing patterns by physicians. Currently, doctors are pushed into prescribing high-cost, brand name drugs when equally effective, less expensive versions may be available.
Call to Action
Even in these difficult economic times, risking access to affordable medications and lowering consumer protections for assisted living are the wrong ways to balance a state budget.
Please call your state legislators toll-free at 1-800-869-5861 and ask them to:
• Preserve the wrap-around coverage for the EPIC program and not require EPIC beneficiaries to enroll in Medicare Part D if it will cost them more money.
• Uphold consumer protections for assisted living residents by opposing the creation of new assisted living spaces that would be exempt from the Assisted Living Reform Law.
• Oppose Medicaid cuts to institutions and home care that would compromise the ability of nursing homes and home care agencies to deliver quality services.
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