Monday, June 25, 2007


Bush Administration takes aim at small pharmacies & the poor

I'm interrupting our normally scheduled debates to take note of a new Bush Administration initiative that threatens local pharmacies and millions of people around the country. Those most at risk are in rural areas and on Medicaid.

At issue is a new Medicaid reimbursement rule that could put retail pharmacies out of business -- particularly in rural areas. Not surprisingly corporate pharmacies like those run by Walmart would not be threatened by the change in Medicaid policy.

Enforcement of the new rule was scheduled to go into effect within a week, but it was delayed until the end of 2007 because of a scream of alarm from 109 members the House of Representatives. In a May 18 letter, both Democrats and Republicans asked Medicaid to delay implementation. Members of Congress from 39 states signed the letter.

The first report I've seen on this is coming from the Kansas Health Institute newswire -- a non-profit news organization that is run by some old colleagues of mine at the Kansas Statehouse. All of them are top-notch journalists.

Writer Jim McClean reports that some fear that if the new rule goes into effect -- and it could still happen -- small pharmacies might have to close.
“In short, the proposed rule would force retail pharmacies out of the Medicaid business,” the members of Congress said in their letter to CMS. “In many underserved areas, losing Medicaid business would mean these critical community pharmacies would go out of business altogether.”

That is not an idle threat, according to Brian Caswell, president of Wolkar Drug in Baxter Springs, who called the new formula “the biggest threat to pharmacies that we’ve ever seen. It is going to be the death knell for many rural pharmacies.”

The nonpartisan Government Accountability Office reported in 2006 that pharmacists would be paid an average of 36 percent below their costs under this rule.

This leaves the pharmacists and states with some awful choices. If the rule is enforced, then pharmacists may have to either close or cut off Medicaid clients, or individual states will have to foot the rest of the bill.

This points out once again one the big lies about Bush's tax cuts. Bushies claim to have saved taxpayers money, but many times the cost of essential services are just shoved off onto the states or to local governments. Taxpayers either pick up the costs of needed services or people suffer. Meanwhile, Bush and friends get to claim that they've saved people money.

This kind of doublespeak would be funny if it didn't hurt so much.

This was cross-posted from In This Moment.