BILL REQ. #:  S-4729.1 

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     TO THE HONORABLE GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES, AND TO THE PRESIDENT OF THE SENATE AND THE SPEAKER OF THE HOUSE OF REPRESENTATIVES, AND TO THE SENATE AND HOUSE OF REPRESENTATIVES OF THE UNITED STATES, IN CONGRESS ASSEMBLED:
     We, your Memorialists, the Senate and House of Representatives of the State of Washington, in legislative session assembled, respectfully represent and petition as follows:
     WHEREAS, Nearly one million residents of Washington state receive health coverage through Medicare and thus became eligible to purchase prescription drug coverage through the Medicare Part D program on January 1, 2006; and
     WHEREAS, Medicare beneficiaries must now navigate a new, complex system for purchasing coverage and receiving prescription drug benefits; and
     WHEREAS, Nearly 100,000 of the 6.4 million Americans eligible for both Medicare and Medicaid, dual eligibles, live in Washington State; and
     WHEREAS, Dual eligibles are sicker and poorer than other Medicare beneficiaries, with more than half of all dual eligibles requiring assistance with activities of daily living, with higher rates of chronic diseases than other Medicare beneficiaries including Alzheimer's disease, diabetes, pulmonary disease, and stroke, and with more than sixty percent of dual eligibles living below the poverty level; and
     WHEREAS, Dual eligibles in this state and across the nation have encountered numerous problems during the first weeks of implementing the new Medicare prescription drug program; and
     WHEREAS, Those problems have included incorrectly charging dual eligibles the $250 deductible that they are exempt from because of their low incomes and failing to consistently inform them that they are allowed to have a 30-day refill of all drugs; and
     WHEREAS, Even modest copays of $1 to $3 per prescription for dual eligibles can become barriers to purchasing life-enhancing medicines when the recipients have 10 to 20 prescriptions a month and often live on less than $600 a month; and
     WHEREAS, The last thing we want to see happen to an already vulnerable population is a worsening of their health conditions resulting from barriers to prompt access to their medicines resulting from implementation of Medicare Part D; and
     WHEREAS, Each prescription drug plan has a different formulary, different copayments, and varied cost-sharing that Medicare beneficiaries have struggled to understand in order to determine which plan has a formulary that not only includes most or all of the beneficiaries' drugs but is also the best value; and
     WHEREAS, Many states will have additional costs associated with the clawback provision of the Medicare law, which requires states to reimburse the federal government for the costs of dual eligibles based on a formula that may not accurately reflect actual costs and numbers of these enrollees;
     NOW, THEREFORE, Your Memorialists respectfully pray that the Congress and the Administration address these concerns through rule making and, as necessary, through changes to the Medicare Modernization Act, by specifically doing the following:
     (1) Upgrading the Centers for Medicare and Medicaid's customer service system to assist clients seeking information;
     (2) Providing additional financial resources to the states to lessen the burden of copays on dual eligibles, particularly those who rely upon multiple prescriptions to maintain their health;
     (3) Extending the enrollment period beyond the May 15, 2006, deadline;
     (4) Requiring all health plans that contract with the Centers for Medicare and Medicaid Services to provide uniform transition policies that provide a 30-day supply of needed drugs;
     (5) Reimbursing states and pharmacists who have been forced to assume the burden of the costs for covering individuals who have fallen through the cracks; and
     (6) Repealing the prohibition on the use of Medicaid funds to provide: Wraparound Medicare prescription drug benefits for the transition of dual eligibles; copayments for dual eligibles and low-income beneficiaries; and needed coverage if a particular plan's restricted formulary or network denies access to the most medically appropriate medications.
     BE IT RESOLVED, That copies of this Memorial be immediately transmitted to the Honorable George W. Bush, President of the United States, the President of the United States Senate, the Speaker of the House of Representatives, and each member of Congress from the State of Washington.