January 17, 2006
President George W. Bush
The White House
1600 Pennsylvania Avenue NW
Washington, D.C. 20500
Dear Mr. President:
We are writing to express our deep concern over the early implementation of the Medicare Part D drug benefit. As Governors, we understand what is required to provide prescription drug coverage. Indeed, many of us have been providing coverage to our citizens for years. While well-intended, the new Medicare drug benefit has caused confusion, mismanagement, and a bureaucratic nightmare.
The horror stories surrounding this new federal program have been widely reported. Since January 1, hundreds of thousands of low-income seniors have had difficulty getting the medicines they need. The hardest hit are those referred to as "dual eligibles," seniors who are eligible for both Medicaid and Medicare. These individuals had been receiving their drugs under state Medicaid programs, but were forced into the new Medicare program, where many have been overcharged, given insufficient coverage, or denied altogether.
States, too, have been forced to bear additional burdens because of this new federal program. As you know, many state governments have taken emergency measures to protect dual-eligibles by continuing to provide drug coverage, even though this is now the responsibility of the federal government. The unexpected cost to states will likely be in the hundreds of millions of dollars. This cost is even more onerous in light of the federal "clawback" on purported state Medicaid savings as a result of the new federal coverage. States have nonetheless taken swift action because we refuse to allow our citizens to be deprived of their medicines while the federal government attempts to implement its new program.
In recent days, your Administration has acknowledged the immediate problems facing our seniors. Your call for insurers to supply 30 days' worth of medicine to all low-income beneficiaries and to limit their co-pay to $5 was a step in the right direction. As these changes are being implemented, however, states will continue to provide stopgap coverage and incur unanticipated costs. We therefore urge you to fully reimburse the costs states have incurred in providing emergency coverage and will continue to incur in the coming transitional period. We also urge you to investigate the underlying causes of these transition problems and assess the extent to which programmatic changes are required to prevent their continuance or recurrence.
As fellow chief executives, we understand the challenge you face, and we are willing to meet with you to discuss how we can cooperate to get seniors the drugs they need in an efficient and affordable fashion. The time for all levels of government to act is now.
Office of Governor Kathleen Sebelius
300 SW 10th 245N, Topeka, Kansas