Pharmacists' fear of Medicaid expansion

Recently, state lawmakers approved pharmaceutical changes in hopes of saving Texas millions of dollars. Despite the fear of many pharmacists throughout Texas, the state pushed for the expansion of prescription drugs to appear on the Medicaid managed care plan. This change will most likely cut the pharmacies reimbursements, and eventually some will be forced to shut down.

Travis County and many other urban or metropolitan areas have successfully used the managed care plan for years. Pharmacists simply looked up the reimbursement rates on the state health agency's website in order to accept most, if not all, client Medicaid plans. Now, pharmacists' no longer have that luxury of accepting numerous different plans. They will have to choose which managed care plans they are going to accept based on reimbursement rates that are still up in the air. If a pharmacy decides to sign a contract that agrees to accept a specific managed care plan, they cannot deny any patient, no matter how low the reimbursement rate, that has that health care plan.

It won't take long before pharmacies start cutting back on deliveries, staff, and any other possible additional expenses. This will create a dramatic drop in pharmaceutical jobs around Texas, and in some cases lead to some shutting down. Medicaid and other health insurance plans are not easy to join, much less switch. Patients that used the same pharmacy or pharmacist for years could potentially be denied their medication because the pharmacy no longer accepts their managed care plan. For those who are older, have little or no transportation, and  have specific needs, picking up their prescription will be extremely difficult and inconvenient. Although the urban areas continue to sign agreements for the managed care plans, the more rural and local pharmacies will not thrive the same way. Patients who need specific medications that are not held in chain drug stores will no longer have the ability to visit their local pharmacy because most will be run out of business.

Including prescription drugs in this expansion of the Medicaid plan scare pharmacists for understandable reasons. Not only does their business suffer, but the quality of service and health of their patients are now at risk. Lawmakers believe this will save Texas $100 million dollars, and it probably will by putting more people out of jobs. The fact is, the state government is more focused on saving money than protecting the rights, jobs, and health of managed care patients and clients.