Wisconsin SeniorCare
           
Advocacy failed, but program survived
  
By Paul Kusuda
     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 " ? 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 " ? 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.
Homepage
August 2007 issue