Corzine Budget Proposal May Put Mentally Ill at Risk

WOODBINE — According to a new study of nearly 600 psychiatrists and more than 1,600 patients, certain state Medicaid practices intended to save money were associated with increased adverse outcomes among mentally ill patients, including more frequent hospitalizations and higher levels of care.
The study, “Medicaid Prescription Drug Policies and Medication Access and Continuity: Findings from Ten States,” appears in the May 2009 issue of Psychiatric Services, a Journal of the American Psychiatric Association. According to the study, patients unable to afford co-payments had a nearly eight times greater likelihood of experiencing an adverse event.
Gov. Jon S. Corzine is proposing that Medicaid beneficiaries pay, a $2 co-pay on prescription drugs with a $10 a month cap. Medicaid beneficiaries who have no income because they can not work due to a mental disability such as Psychophrenia would also be required to pay the $2 co-payment as the proposal makes no exceptions for beneficiaries with zero income. Corzine hopes to raise $4.6 million dollars with the proposed co-payments as part of the largest one-year spending cut in state history this year.
The Mental Health Association in New Jersey opposes the co-payments because the proposal will limit access to care. The association has joined a group of advocates and providers including the AARP, ARC that have formed the Coalition for a Moral Budget, which believes that imposing co-payments on Medicaid beneficiaries and individuals with HIV/AIDS will harm the most vulnerable New Jerseyans and will not result in actual savings to the State.
The coalition published an impact analysis that cites several studies that show the impact of co-payments and other cost constraining measures on medications have negatively impacted patients’ access to medications and patients’ that stop taking medication due to co-payment cost require more costly hospital services, that are ultimately billed to Medicaid.
Greg Speed, CEO of Cape Counseling Services has watched this proposal introduced several times over the years only to be defeated each year. Speed fears this time the co-payments may become a reality. Speed says the financial burden on the disabled and disadvantaged may cause patients to forgo taking their medication if they need the money for day-to-day needs. Patients’ that stop taking their medication who otherwise function in the community could require a higher level of care, Speed said.
Julia Hankerson, who runs the Woodbine Wellness Center, said she agrees with the study’s findings and has personally watched higher income senior citizens who do not qualify for the states Medicaid program forgo filling prescriptions to buy food and other necessities when faced with the choice.
“The people on Medicaid the poorest of the poor, the results will be no different. I know people personally who have Medicaid and it’s the only way they are getting their medicine and getting therapy, years of government miss management should not be paid for on the backs of needy who did cause the current problems,” said Hankerson.
Corzine’s press office was provided with a copy of the study with a request for comment from the governor on the study’s findings.
According to Deborah Howlett, Corzine was unavailable for comment by the story’s deadline, but Howlett did provide the Herald with this statement:
“The governor has been quite clear that given the national economic crisis and the $7 billion state budget shortfall, there were some tough choices on programs that might otherwise not have been made. The co-pays for seniors have a $10 a month cap, which is in line with what most other states do. And as difficult as some of the choices were, the governor has made the right choices in keeping hundreds of thousands of dollars for the senior property tax freeze and rebates to ensure seniors are able to stay in the homes where they now live.”
Sen. Jeff Van Drew was also provided with a copy of the study.
“We are very concerned with his issue as well,” Van Drew said. “Less compliance by these patients in taking their medication increases their own physical and mental risk which ultimately will increase costs to the state and its communities which will be both fiscal and social in their nature”
Read the Medicaid Prescription Drug Policies and Medication Access and Continuity: Findings from Ten States study here (pdf file)
Contact Scheeler at 609-404-6515 or hscheeler@cmcherald.com