Medicare, Part D, prescription drug plans are frequently not available for low-income Americans who do not qualify for Medicaid. (The asset tests to qualify for help leave out many who still must choose their priorities.)

According to a tracking report at change.com,

The most vulnerable people—the uninsured, those with low incomes, people in fair or poor health, and those with multiple chronic conditions—continued to face the most unmet prescription needs. For example, 48 percent of uninsured people in fair or poor health went without a prescription drug because of cost concerns in 2010, almost double the rate of insured people with the same reported health status.
Too often seniors go without care for chronic or acute conditions, ultimately leading to more critical and expensive medical emergencies and conditions that the taxpayers ultimately end up paying for through Medicaid when seniors spend down their assets or otherwise qualify for Medicaid.  Low-income, moderate asset seniors are already juggling priorities and stretching their resources as far as possible to maintain their independence from public assistance. This frequently means no prescription drug coverage and not having real access to preventive care that would actually improve health, despite being covered by Medicare Parts A and B, and perhaps even a Medigap policy.

Folks with moderate assets have to make tough choices on what policies to buy and what chances to take.  Frequently they are making these choices on Social Security checks of less, or much less, than $700/month.

The Affordable Care Act that will be kicking in in 2014 will help some younger and working folks, but also will still leave the loopholes that Medicare Part D programs are allowed.  These include significatn deductibles, co-pays, and other limitations.

In 2014, the 2010 Patient Protection and Affordable Care Act (PPACA) is expected to extend prescription drug coverage to tens of millions of uninsured Americans via expansions in Medicaid eligibility and subsidized private coverage in health insurance exchanges. Although prescription drug coverage is an “essential benefit” to be provided by health plans participating in the state health insurance exchanges, flexibility in plan design leaves room for benefit limits, including patient cost sharing, prior authorization, preferred drug lists, dispensing limits and other utilization management tools, that may affect gains in access.
According to "Bitter Pill" in Time Magazine, Congress could help significantly by changing the law the disallows the government from negotiating for better prescription drug costs.  Some estimate that negotiating for better prescription drug prices would save more than we are saving with the job-killing, nonsensical sequester cuts.
We should amend patent laws so that makers of wonder drugs would be limited in how they can exploit the monopoly our patent laws give them. Or we could simply set price limits or profit-margin caps on these drugs. Why are the drug profit margins treated as another given that we have to work around to get out of the $750 billion annual overspend, rather than a problem to be solved?

Just bringing these overall profits down to those of the software industry would save billions of dollars. Reducing drugmakers' prices to what they get in other developed countries would save over $90 billion a year. It could save Medicare — meaning the taxpayers — more than $25 billion a year, or $250 billion over 10 years.

Read more: http://www.time.com/...


Lower costs for prescription drugs could lead to lower costs for prescription drug plans as

If the goals are greater health and less cost to the taxpayer for health care, then preventive care, including improved access and more affordable costs for prescription drugs are items that need to be high on the Congressional priority list.


Should Congress negotiate for improved prescription drug costs?

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