Increases income eligibility levels in the EPIC program

20 Co-sponsors

• Eric Adams
• Joseph P. Addabbo Jr.
• Neil D. Breslin
• Ruben Diaz
• Martin Malavé Dilan
• Thomas K. Duane
• Ruth Hassell-Thompson
• Shirley L. Huntley
• Liz Krueger
• Carl Kruger
• George Onorato
• Suzi Oppenheimer
• Kevin S. Parker
• John L. Sampson
• Diane J. Savino
• Malcolm A. Smith
• William T. Stachowski
• Toby Ann Stavisky
• Antoine M. Thompson
• David J. Valesky

Title of bill

An act to amend the elder law, in relation to eligibility levels in the elderly pharmaceutical insurance coverage program

Purpose

Increases income eligibility levels in the EPIC program.

Summary of provisions

Section 1 Provides coverage for those who are at least 65 years of age and whose income is less than fifty-thousand dollars annually for an unmarried person, and less than seventy-five thousand dollars annually for a married couple.

Section 2 Establishes deductibles based on income for unmarried individuals and married couples.

Section 3 Establishes co-payments based on income for unmarried individuals and married couples.

Section 4 Effective date.

Existing law

Income eligibility in the Elderly Pharmaceutical Insurance (EPIC) Program is limited to no more than $35,000 annually for single individuals and no more than $50,000 annually for married couples.

Justification

The cost of prescription drugs is widely regarded as the most expensive component in the provision of health care services. HMOs, employers, senior citizens and the uninsured continually worry about the rising cost of prescription drugs. Federal, state and local governments continually search for ways to control spending by reducing reimbursement to pharmacies, restricting coverage to less expensive generic drugs, or requiring "prior approval" in government funded prescription drug programs. For senior citizens, the problem of the spiraling costs of prescription drugs is even more serious. While senior citizens make up only 15% of the population, they use 35% of the nation's medications. Older Americans without prescription drug coverage typically pay 15% more for prescription drugs. Prescription drugs account for the largest single source of out-of-pocket health care costs for Medicare beneficiaries. The elderly and the uninsured are impacted disproportionately by reductions in retirement prescription drug Coverage, decreases in HMOs' prescription drug benefits, and steep increases in prescription drug prices. Since 19B6, the Elderly Pharmaceutical Insurance Coverage Program (EPIC), New York State's prescription plan for senior Citizens who need help paying for their prescriptions, has assisted hundreds of thousands of senior citizens. Currently, 340,000 enrollees are Saving, on average, over 80% on their prescription drug costs. It is therefore incumbent upon the Legislature to assist the state's elderly citizens in purchasing prescription drugs. This bill attempts to lessen the harsh economic impact prescription drug prices have on senior citizens by increasing income eligibility levels in the EPIC program to $50,000 for Single individuals and $75,000 far married Couples.

Legislative history

2006 - S.2809 - Referred to Aging 2008 - S.2257 - Referred to Aging; Motion to Petition - Lost

Fiscal implications

Fiscal implication for 2009-10 is $1.55 million for New York State.

Effective date

Immediately.