Congress will soon be back to work on healthcare reform and we will again be working for passage of comprehensive reforms that ensure every American has access to first-class healthcare. We share the concerns of many Americans, as mentioned before, that legislation approved by the House Energy and Commerce Committee is unfortunately not headed in the right direction.
A bill passed by that committee includes a public plan option, run by the federal government, that would use a one-size-fits-all national drug formulary to control prices. Our principle concern is that this would in turn greatly reduce a doctor's discretion and a patient's access to necessary medicines. There is no requirement in the bill that the public plan have experts or physicians involved in determining what medicines would be included in the formulary or that it ensures adequate access to a sufficient number of medicines in each class.
The Veterans Affairs drug formulary and Medicaid drug coverage suggest how access and options could be restricted if this public plan is enacted into law. The VA covers far fewer drugs than Medicare Part D, the prescription drug benefit enacted in 2006.
A recent study by the Lewin Group on the 2009 formularies found that of the 281 most prescribed Part D covered drugs, 277 (99%) are covered in the highest enrollment Part D plan, and 255 (91%) in the second-highest enrollment Part D plan. By contrast, only 187 (67%) are included in the VA formulary. Additionally, state Medicaid plans often impose restrictions, such as script limits, on access to drugs not seen in Part D.
Any healthcare reform must be rooted in a commitment to giving more Americans better access to healthcare. For us, limiting access to potentially life-saving medicines is not an appealing option, and not in the public interest.
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