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UPDATE: Nixon signs extension of Missouri prescription plan

Friday, June 10, 2011 | 3:30 p.m. CDT; updated 5:05 p.m. CDT, Tuesday, June 14, 2011

ST LOUIS — A looming end to prescription drug subsidies for more than 200,000 lower-income elderly and disabled Missouri residents was averted Friday as Gov. Jay Nixon signed legislation reauthorizing the program for three more years.

The Missouri Rx Plan was due to expire Aug. 28, and efforts to renew it had stalled in the Missouri legislature before the bill ultimately passed on the final day of the session last month. Nixon, who called for the extension, traveled Friday to a St. Louis pharmacy at a community health center for a bill signing ceremony.

"This program, and the hundreds of thousands of people it serves, was in real jeopardy," Nixon said. "With my signature, hundreds of thousands of Missourians will get the support they deserve."

Under the Missouri Rx Plan, the state pays half the Medicare deductibles and copayments on prescriptions for individuals with annual incomes up to $21,660 or married couples earning up to $29,140. There is no cost to enroll in the program. The Missouri Department of Social Services said 212,377 people currently participate in Missouri Rx, though that figure varies from month to month.

The program marks Missouri's third attempt at helping seniors pay for their medicine. In 1999, lawmakers approved a state income tax credit of up to $200 for people age 65 and older. But that program did not last long because its $85 million cost was quadruple what was expected.

During a September 2001 special session called by then-Gov. Bob Holden, lawmakers scrapped the tax credit in favor of a new Missouri Senior Rx Program, which paid up to 60 percent of the prescription costs for individual seniors earning no more than $17,000 annually and couples making up to $23,000. That program was intended for people covered neither by private prescription insurance nor the state's Medicaid health care plan for the poor.

In 2005, lawmakers changed the program again to mesh with the new prescription drug benefits offered under the federal Medicare program for seniors and the disabled. Of chief concern to state lawmakers at the time was the so-called "doughnut hole" in the federal plan, which causes people to pay the full out-of-pocket cost for medicines after exceeding a certain coverage threshold and before hitting a higher mark upon which government again picks up most of the price.

Some lawmakers this year questioned whether it was necessary to continue the program because the new federal health care legislation signed by President Barack Obama reduces out-of-pocket prescription costs for people covered by Medicare.

But Nixon said the "doughnut hole" issue may continue to be a problem for seniors for some time. Missouri has spent about $20 million annually on its program. Nixon said about 20 other states have similar prescription programs.

"It defrays dramatically the costs, especially of those long-term type of drugs, and quite frankly is a cost-differential lifeline that's made a difference for over 200,000 Missourians a year," Nixon said.


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