December 22, 2005
CHALLENGE IN MISSISSIPPI
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STAND-UP GUY: Webb whips up crowd at press conference announcing suit |
Ever since July, when we began covering Mississippi's new policy restricting Medicaid recipients to five drugs (with only two brand-name), we've hinted that Housing Works—which opened an office in the state this fall in partnership with AIDS Action in Mississippi (AAIM)—might take part in a legal challenge to the harsh new rule. And sure enough, last Thursday afternoon in the rotunda of the state capitol in Jackson, reps from HW were among those who called a press conference to announce that eight plaintiffs had filed a suit against the policy.
One in four residents relies on Medicaid in Mississippi, whose restrictive new policy imperils tens of thousands who depend on the program to cover treatment for one or more chronic illnesses, such as cancer, heart disease, hypertension, diabetes, multiple sclerosis, mental illness and/or HIV/AIDS. Medicaid recipients with HIV/AIDS, who generally require three or more branded meds to treat HIV alone, have been informally exempted from the two-brand-name cap but are still subject to the policy's total cap of five meds.
The press conference captured the attention of Mississippi's Clarion-Ledger, which also ran this op-ed saying that the Medicaid policy should assess patient drug needs on "a case-by-case basis." Meanhwhile, an Associated Press story featured plaintiff Glenda Fay Dennis, 52, of Eupora, who requires 13 medications to treat her illnesses. Since the five-drug limit began, "I've been playing a dangerous game of filling five prescriptions each month," Dennis said, "and praying that my one-month prescriptions somehow will last two months or more."
MOVING FORWARD
The lawsuit alleges that the Mississippi policy's "hard cap" on meds—which limits patients to five prescriptions even if a doctor asserts that more are medically necessary—is not legal under federal Medicaid legislation passed in the 1990s. "At that time, Congress told states very specifically the permissible limitations in their Medicaid drug programs, and so-called hard-caps were not one of them," said senior Housing Works attorney Armen Merjian, who filed the suit with lawyers from the Mississippi Center for Justice, AARP Foundation Litigation, the National Health Law Program and the National Senior Citizens Law Center.
"This is such a dangerous policy," said Merjian. "When interviewing plaintiffs for the case, we heard stories of individuals selling household goods and living on ketchup and mayonnaise sandwiches to pay for needed meds, or simply rationing or going without monthly supplies of drugs."
A hearing date in federal district court may come as soon as this week or next, according to Merjian, who notes there is still time for Barbour and the state Medicaid division to amend the policy, such as by allowing doctors to overrule the hard cap when necessary. The case will set an important precedent regarding other states' attempts to impose similar hard caps, says Merjian.
KEEPING ON THE HEAT
The press conference was organized by Robin Webb and Shannon Reaze, AAIM founders and staffers of HW's new office in Jackson, which aims to help galvanize HIV/AIDS activism in Mississippi. Mary Troupe, executive director of Mississippi's Coalition for Citizens with Disabilities, also played a key role in the organizing, as did the Mississippi branch of AARP.
Because the conference announcing the suit was hastily organized after two weeks of negotiations between the state's attorney general and the governor's office reached a stalemate, no plaintiffs could make it to the press conference, said Webb. Still, he said, the conference was lively. Now, he said, until the case was decided, AAIM's job was to "keep the buzz alive in the community and the media."
AIDS Issues Update will keep you posted.