“Please do what you can to keep SeniorCare as is. It is critical to those of us on it.” wrote a rural Buffalo County woman.
“I will be 70 years old in a couple of months and not on any prescription medicines. SeniorCare is perfect for me as I very seldom require a prescription for illness or injury, usually going for a year or more without needing one. I should not have to pay the outrageous high cost of Medicare Part D which I would very seldom use and it would cause a terrible financial burden for me that I could not handle on my fixed income.”
The rural woman I’ll call ‘Dawn’ signed her letter, “Thank you from a very satisfied SeniorCare participant.”
Slipped into the Governor’s state budget is a requirement that seniors sign up for Medicare Part D before they sign up for SeniorCare. The program is a substitute for Part D.
To justify his action, the Governor told the Wisconsin State Journal “It’s not about changing benefits; it’s ultimately about changing who pays for it.”
According to Dawn that is the problem.
She figures under the Governor’s new plan she’d pay $60 a month. Now she pays $30 a year. “I shouldn’t have to pay an outrageous bill for something I won’t use,” she said in a recent phone conversation.
SeniorCare is truly a Wisconsin invention. It is the only state-based alternative to the complicated maze of plans comprising Medicare Part D – the drug benefit for seniors.
To participate in SeniorCare, people must be Wisconsin residents, over age 65, and meet an income requirement. The program has a simple one-page enrollment form and requires a $30 annual fee. Folks pay a deductible and small co-payment of $15 for brand name and $5 for generic prescriptions.
Seniors love the program, as do health care workers, pharmacists, nursing homes and elder advocates. Not only is the program simple, it is also less expensive. In 2011, the Legislative Fiscal Bureau (LFB) estimated that SeniorCare saves the federal government $85.8 million a year.
SeniorCare is a state-run program while Medicare Part D involves the sale of private insurance policies under federal government rules. Part D plans differ quite a bit with different formulas for coverage, different deductibles, different coinsurance and different lists of drugs covered. In addition, plans offer different levels of coverage in the “doughnut hole” — gap in coverage.
Part D plans require seniors to pay a monthly premium, in addition to the per-prescription copayment and the deductible. Seniors tell me the Part D premium alone could easily be 24 times the annual $30 cost of SeniorCare.
SeniorCare depends partly on federal Medicaid funds. To continue to get federal funds, Wisconsin must periodically prove to the feds through a waiver request that they are saving taxpayers’ money. Unlike Part D Medicare, one way that SeniorCare saves money is to negotiate with drug companies.
This is the second time the governor proposed doing away with SeniorCare as we know it. In 2011, a statewide petition drive saved the program.
Spearheading the petition drive was Representative Andy Jorgenson. He was recently quoted in the Milwaukee Journal Sentinel: "What is wrong with Governor Walker? Did he not get the message the first time, or doesn't he care? … Governor Walker is pushing a plan that will hurt seniors financially."
In 2011 people collected over 15,000 signatures. Moments after the signatures were delivered to lawmakers, Republicans pledged their support for SeniorCare.
Dawn knew about the success of the first petition drive and was already at work.
“I spent all day Saturday and Sunday sending emails,” she told me. “Most [lawmakers] sent a letter back saying they were not accepting emails. It was frustrating. Don’t you think if they represent Wisconsin they should accept my email?”
When I complemented Dawn on her persistence she said, “What scares me is that $60 a month,” she paused and nearly whispered, “I’m not going to be able to buy groceries.”