Wisconsin SeniorCare
Advocacy failed, but program survived
By Paul Kusuda
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Wisconsin SeniorCare was scheduled to end June 30, 2007 because of the federal Department of Health and Human
Services' reluctance to provide a waiver enabling continuation. Without a DHHS waiver, about 105,000 senior
Wisconsinites would have to move from SeniorCare to a pharmaceutical drug plan under Medicare Part D, a switch that
would increase their prescription drug costs. Efforts to obtain such a waiver began over nine months prior to June 30.
Prospects looked dismal.
Members and staff of the Coalition of Wisconsin Aging Groups (CWAG), American Association of Retired Persons
(AARP), Wisconsin Alliance for Retired Americans (WARA), and many other organizations along with other concerned
Wisconsinites implored many times to the U.S. DHHS for a waiver. Wisconsin's Congressional delegation, consisting of
all Wisconsin members of Congress, unanimously requested such a waiver by making its bipartisan stance known to the
DHHS Secretary. A positive response was not forthcoming; SeniorCare did not fit the DHHS model established by
Congress and fully supported by the administration.
The oddity is that if DHHS granted the requested waiver, SeniorCare enrollees, the federal government, and Wisconsin
would all save money. Part of the savings result from the fact that Wisconsin negotiates with drug companies for reduced
prescription drug prices on the basis of volume purchases. Such negotiation is prohibited for Medicare Part D by federal
law.
An analysis by the state and AARP showed that " Â… more than 94 percent of seniors are better off on SeniorCare than
they would be under Medicare Part D because co-payments are lower and the coverage is more comprehensive." (State of
Wisconsin Fact Sheet - 2007)
As noted above, many were involved in the efforts to obtain a DHHS waiver; however, partisan politics were too deeply
involved in decision-making. In February 2007, Governor Jim Doyle wrote to U.S. Senator Russ Feingold:
"Everyone in Wisconsin agrees that SeniorCare is a very effective program. Throughout the past year, as our seniors had
to choose between SeniorCare and Medicare Part D, they overwhelmingly chose SeniorCare -- To date, the state has only
received a brief letter from DHHS acknowledging receipt of the waiver extension application. I need your assistance in
persuading Secretary Leavitt ... to extend SeniorCare -- Time is running short and Wisconsin needs your continued
assistance in saving the very successful SeniorCare program ... I thank all the members of the Wisconsin delegation for
their support ..."
Copies went to each member of the Wisconsin delegation.
In a March 6, 2007 letter sent to many Wisconsinites, Gov. Doyle provided up-to-date information about the current status
of SeniorCare and what the program does to help seniors meet prescription drug prices. He pointed out that he supported
full funding for Wisconsin's share of SeniorCare in every budget since 2003 when he vetoed a section of the Legislative
Budget Proposal that would have raised co-payments by a third. He also reported that in October 2005, he "... negotiated
an agreement with the federal government to allow SeniorCare to continue through June 30, 2007. Without that agreement,
the program could have been terminated as of January 1, 2006." He suggested that letters be sent to DHHS Secretary Mike
Leavitt and President Bush. Many people sent letters -- with no results. Advocacy efforts fell on deaf ears. (Like Don
Quixote, many of us, though acting rationally, were apparently tilting with bureaucratic windmills. That happens to
advocates, but we don't all give up.)
In early April 2007, DHHS decided to deny a three-year waiver that would have allowed continuation through 2010. In a
final effort, Gov. Doyle and U.S. Senator Herb Kohl met with DHHS Secretary Leavitt to request a six-month extension to
December 31, 2007, in order to plan for the projected June 30 termination date. An alternative program called
WisconsinCare was being developed, but time was needed to enable fiscal planning.
Finally, ("O frabjous day! Callooh! Callay!" -- from Jabberwocky by Lewis Carroll) on April 24, 2007, a news release
announced that U.S. Senator Her Kohl and U.S. Senator Russ Feingold successfully included " Â… a two-and-a-half year
extension of SeniorCare, Wisconsin's popular senior drug coverage program, in the Iraq Supplemental Conference
Report, a bill that also includes funding for disaster aid, veterans' health, agricultural disasters, and other emergency
funding -- Extending SeniorCare through December 31, 2009 will provide $26 million in savings over five years. This two-
and-a-half year extension will allow Wisconsin a reasonable amount of time to determine the best course of action to
ensure that seniors do not lose their current prescription drug coverage."
Generally, I do not support adding non-related amendments (called "pork") to appropriation bills; however, in this
instance, I cannot object. The Iraq Supplemental Conference Report successfully passed the approval process, and
SeniorCare will continue through the end of 2009. Advocacy failed, but through an undesirable alternative, an excellent and
needed prescription drug program for seniors will continue for awhile.