Benefits and Consequences for the Poor and the Disabled

The new Medicare Part D will improve access to medications for millions of Americans. One subgroup of beneficiaries, however, may inadvertently be made worse off: the 7.2 million people enrolled in both Medicaid (because they are poor) and Medicare (because they are elderly or disabled). These beneficiaries, known as the dually eligible, already receive drug benefits through state-run Medicaid programs; but as of 2006, they will be required to enroll in Medicare Part D. Moving the dually eligible recipients of drug benefits to new federal programs raises several concerns: these beneficiaries may have problems making the transition and negotiating the system; they may discontinue use of essential medications because of increased cost sharing; they may need to switch medications because their new plan offers different coverage from their old one; and they may have difficulty obtaining essential medications because of formulary restrictions