Schweitzer Proposal Would Offer All Montanans Medicaid Drug Discounts

Press Release

Governor Brian Schweitzer will submit today a draft research and demonstration waiver proposal that would allow Montana to make prescription drugs more affordable. The waiver will be submitted to the Centers for Medicare and Medicaid Services (CMS).

"The cost of prescription drugs has gone way up in the past decade. This is a way to save money on the cost of prescription drugs," said Governor Brian Schweitzer. "No one should be forced to make decisions about whether or not to buy medicine," said Governor Schweitzer.

The waiver will allow Montana to provide the discounts the Medicaid program receives on medications to all Montanans. Under the waiver, dubbed Medicaid Part D, Montana could negotiate the same price breaks for everyone that the state receives for people on Medicaid, the state-federal health-care program for people with low incomes.

The savings -- about 55 percent on the retail price--would be passed on to all Montanans. Enrollment would be optional and open to Montana residents who apply and are U.S. citizens. Those with prescription drug coverage through private insurance could also participate and decide whether to pay their insurance co-pay or the Medicaid price--whichever was least costly. The program also would cover elderly residents on Medicare whose coverage runs out. If granted, this waiver would reduce what seniors pay for medications if they are in the donut hole immediately.

Schweitzer compared the prices Montana pays through Medicaid for drugs to the prices offered by a popular Montana Medicare Part D plan for seniors. Of the 20 drugs commonly prescribed to seniors, Medicare charged prices that were substantially higher than those obtained by Medicaid.

Schweitzer estimates that if Medicare adopted similar policies to the waiver he proposes, Medicare Part D would save 46 percent. That translates to an estimated $96 million in Montana, and about $27 billion nationwide for Medicare Part D.

If approved, the Montana Medicaid Part D program would be the first of its kind in the nation.

There is a 60 day public consultation and notice required for the waiver. The public is invited to review and provide input on this waiver. The waiver will be posted on the DPHHS website (under frequently requested publications) and reviewed at a public hearing.

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