MORx – Encouraging Words From State Senate (Update)

During the last legislative session, the rules of eligibility for the MO Rx program were changed. Previously, seniors who qualified under Medicare rules were eligible for the program. The change required that seniors be qualified under both Medicare and Medicaid guidelines. As a result, 60,000 seniors lost prescription drug assistance under the MO Rx program.

Two outcomes are likely as a result of this massive change. One scenario is that seniors who are unable to afford their prescription medications will realize worsening medical problems until they become acute and may be faced with more extensive nursing home care. Another scenario is that seniors may try to pay for these prescriptions on their own and spend themselves into Medicaid.

(During last week’s legislative discussions, the Missouri State Senate indicated that they will try to restore funds for MORx to the budget and then work out details in conference committee with the Missouri House.

Contact your state senator today to help preserve these important program changes.

MA4 supports the Senate’s intended approach to SB 563 which fully restores the MO Rx program to its previous eligibility standards and covers both Medicare and dual-eligible seniors. We encourage you to contact your representative to discuss the following important points:

  • Ma4 supports MO Rx because it is vital in providing medication access to 240,000 eligible seniors and individuals with disabilities in Missouri. 
  • MO Rx does this by paying 50% of out-of-pocket costs for medications that are covered by a senior’s Medicare Part D plan, including the cost of the deductible and co-payments.  
  • Moreover, MO Rx continues to provide benefits when seniors are in the Medicare Part D coverage gap, also known as the “donut hole.” 
  • To qualify for MO Rx: must be a Missouri resident; enrolled in a Medicare Part D Plan and single — with an annual gross household income of $21,660 or less or married — with an annual income of $29,140 or less.
    • The Area Agencies on Aging work to help keep seniors healthy and independent and able to live in their communities for as long as possible. Proper medication management is key to this, as it helps seniors manage their chronic illnesses. This, in turn, reduces the cost to the state for nursing home care and for other services.
    • It is estimated 12% of nursing home admissions and 10% of hospital admissions are due to medication non-compliance.
    • While seniors comprise 13% of the US population they utilize more than 25% of all prescription drugs. One in five (5) elderly takes at least five (5) prescriptions per day. So this program is vital to this population.
    • And with increasing costs of prescription drugs, Mo Rx is becoming even more critical to Missouri’s seniors.
    • According to a report in America’s Health Insurance Plans Solutions Smart Brief (3/28/18) prices for 20 of the most commonly prescribed brand-name drugs for Medicare Part D recipients rose 12% annually from 2012 to 2017, almost 10 times higher than the average annual inflation rate. The cost of the drugs, which include brands like Advair, Crestor, Lyrica and Nexium, all increased an average of 12 percent every year for five years — nearly 10-times higher than the rate of inflation, the report found. Twelve of those drugs saw their prices increase by more than 50 percent in the five-year period. Six of the 20 had prices increases of over 100 percent.
    • MO Rx protects Missouri’s seniors from having to make a choice between filling their prescriptions or buying food or other necessities.

 Senate Appropriations Committee Members

Senator Dan Brown, 16th,

Chairman Senator Mike Cunningham, 33rd

Senator S. Kiki Curls, 9th

Senator Dan Hegeman, 12th

Senator Jason Holsman, 7th

Senator Denny Hoskins, 21st

Senator Jamilah Nasheed, 5th

Senator Caleb Rowden, 19th

Senator David Sater, 29th

Senator Rob Schaaf, 34th

Senator Wayne Wallingford, 27th

Vacancy

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