I
105TH CONGRESS
1ST SESSION
H. R. 2681
To establish a program of pharmacy assistance fee for elderly persons who
have no health insurance coverage.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 21, 1997
Mr. KENNEDY of Rhode Island (for himself, Mr. CAMPBELL, and Mr. SAND-
ERS) introduced the following bill; which was referred to the Committee
on Commerce
A BILL
To establish a program of pharmacy assistance fee for elderly
persons who have no health insurance coverage.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Making Affordable
Prescriptions Available for Seniors Act’’.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) although prescription drugs represent one of
the most frequently used medical care interventions
in treating common acute and chronic diseases,
many Americans, especially the elderly and other
vulnerable populations, are unable to afford their
medication because of excessive and persistent drug
price inflation;
(2) between 1985 and 1991, the prices of the
20 top selling prescription drugs, which account for
almost a third of prescription sales, rose 79 per-
cent—nearly 4 times the general rate of inflation;
(3) prescription drug manufacturers continue to
make enormous profits on the backs of the elderly,
poor, and other vulnerable populations that are un-
able to afford their medications;
(4) because of the limited availability of private
or public prescription drug coverage for the elderly,
prescription drugs represent the highest out-of-pock-
et medical care cost for 3 of 4 elderly patients, sur-
passed only by the cost of long-term care services;
(5) individuals over the age of 65 fill an aver-
age of 15 prescriptions a year to treat chronic health
conditions compared to an annual average of 5 pre-
scriptions for those under the age of 65;
(6) 90 percent of Americans who are 60 years
of age or older take one or more medications daily;
(7) The United States spends several billion
dollars on biomedical and related health research
and in 1994 the United States spent $33 billion on
such research and the pharmaceutical industry only
spent $14 billion on such research in such year; and
(8) The pharmaceutical industry makes large
profits off of the sale of drugs produced from the
benefit of research paid for by the United States
and, aside from royalties, none of such profits are
reimbursed back to the United States taxpayers.
SEC. 3. PRESCRIPTION DRUG ASSISTANCE PROGRAM.
The Public Health Service Act is amended by adding
at the end the following:
‘‘TITLE XXVIII—PRESCRIPTION
DRUG ASSISTANCE PROGRAM
‘‘SEC. 2801. ESTABLISHMENT.
‘‘(a) IN GENERAL.—The Secretary shall establish a
program of pharmacy assistance (referred to in this title
as the ‘program’) for eligible persons.
‘‘(b) ADMINISTRATION.—Pharmacy assistance shall
be provided under the program to eligible persons in the
manner that the Secretary determines to be the most cost-
effective, including indemnification, vouchers, coupons, or
direct provider reimbursement through the claims pay-
ment system under title XIX of the Social Security Act,
except that no system of administration shall make direct
cash payments to an eligible person before the presen-
tation of a receipt or other invoice for the purchase of any
covered benefit. The Secretary may implement utilization
review, clinical management, and other administrative
techniques used in the management of the pharmacy bene-
fits program under title XIX of the Social Security Act
in order to identify and reduce drug interactions, overutili-
zations, therapeutic duplications, or early refills.
‘‘(c) INCOME LEVELS.—The Secretary may authorize
local councils on aging, community action agencies, and
home care corporations to assist the Secretary in deter-
mining if persons meet the income eligibility requirements
of the program.
‘‘(d) FEE.—The Secretary may require an annual en-
rollment fee in an amount not to exceed $15 to be paid
to defray the administrative expenses of the program.
‘‘(e) OTHER PROGRAM ITEMS.—The Secretary shall
develop copayment requirements and may establish
deductibles to control program expenses. Copayment
amounts may vary to promote the purchase of generic
drugs and may be based on a sliding income scale, except
that copayment shall not be more than $10 per prescrip-
tion.
‘‘SEC. 2802. PROFITS FROM RESEARCH.
‘‘(a) IN GENERAL.—Except as provided in paragraph
(2), any manufacturer of a drug which submits, in connec-