In the shadow of the COVID-19 pandemic, as Gov. Dan McKee and the Rhode Island General Assembly move to hammer out a Fiscal Year 2022 budget, Senate lawmakers push a package of eight legislative proposals to put the brakes on skyrocketing cost of prescription drugs.

The Senate resolution (2021-S0560) sponsored by Senate Majority Whip Maryellen Goodwin (D-Dist. 1, Providence), has already passed and complements the prescription drug affordability package that would require health insurers to provide coverage, without cost sharing, for colorectal screenings and follow-up colonoscopies when necessary. The package of legislation aims to protect Rhode Islanders by limiting co-pays for insulin, capping out-of-pocket expenses for high deductible plans, requiring health insurers to cover preventive colorectal cancer screening, eliminating clauses hidden in pharmacy contracts that prevent a pharmacist from talking about more affordable options, requiring transparent pricing information, importing wholesale prescription drugs from Canada, and creating a board responsible for evaluating and ensuring drug prices are affordable.

According to Greg Paré, the state Senate director of communications, this package of legislative proposals was developed in conjunction with AARP during the off-session before the 2020 Senate session and first submitted last year, but legislation considered last session was limited due to the pandemic and so it did not pass. The legislation has been resubmitted this year with some small modifications and remains a Senate priority.

Hearing is this Thursday

Last year, AARP along with 14 groups, including, the Alzheimer’s Association, the American Cancer Society Action Network, and Aging in Community, urged lawmakers to pass the package of legislative proposals. Expect to see some of these groups again call for passage of either the total package or specific bills at a Senate Health and Human Services Committee’s virtual hearing, chaired by Sen. Joshua Miller, on Thursday, at 5 p.m. For the hearing’s agenda, go to:  For hearing details go to: http://status.rilegislature.gov/documents/agenda-17199.pdf. Passage of this legislative package would require action by both the Senate and House. At press time, not all of the Senate bills had companion measures in the House.

Controlling the Skyrocketing Increase of Prescription Drugs here are specifics about the Senate’s prescription drug affordability legislative package that will be considered by the Rhode Island’s Senate Health and Human Services Committee:

Legislation (2021-S 0170) sponsored by Sen. Melissa A. Murray (D-Dist. 24, Woonsocket, North Smithfield), would limit the co-pay for prescription insulin to $50 for a 30-day supply for health plans that provide coverage for insulin. Additionally, the bill mandates that coverage for prescription insulin would not be subject to a deductible.

Legislation (2021-S 0381) sponsored by Senate Majority Leader Michael J. McCaffrey (D-Dist. 29, Warwick), would cap out-of-pocket expenses for prescription drugs at the federal minimum dollar amount for high-deductible health plans, currently $1,400 for individual plans and $2,800for family plans. The bill (2021-S 0383), sponsored by Sen. Goodwin, would save lives by requiring health insurers cover preventive colorectal cancer screening in accordance with American Cancer Society (ACA) guidelines. This coverage must be provided without cost-sharing and includes an initial screening and follow-up colonoscopy if screening results are abnormal. The ACA recommends people at average risk of colorectal cancer start regular screening at age 45.

A bill (2021-S 0497) sponsored by Sen. Walter S. Felag Jr. (D-Dist. 10, Warren, Bristol, Tiverton) would allow consumers to pay less for their prescription drugs by banning gag clauses sometimes found in pharmacy contracts that prevent a pharmacist from talking to a customer about more affordable options.

This bill (2021-S 0494) would require pharmaceutical drug manufacturers, pharmacy benefit managers, health insurers, and hospitals to disclose certain drug pricing information. Such transparency would help payers determine whether high prescription costs are justified. This bill is sponsored by Senate President Dominick J. Ruggerio (D-Dist. 4, North Providence, Providence).

A bill (2021-S 0499), sponsored by Sen. Louis P. DiPalma (D-Dist. 12, Middletown, Little Compton, Newport, Tiverton), would create a state-administered program to import wholesale prescription drugs from Canada, which has drug safety regulations similar to those of the United States. Such programs are allowed under federal rules, with approval from the U.S. Department of Health and Human Services. This legislation (2021-S 0498) would create a prescription drug affordability board tasked with investigating and comprehensively evaluating drug prices for Rhode Islanders and possible ways to reduce them to make them more affordable. The bill is sponsored by Sen. Cynthia A. Coyne (D-Dist. 32, Barrington, Bristol, East Providence).

A bill (2021-S 0496) introduced by Sen. Felag aims to protect consumers from unexpected changes in their health plan’s formularies (list of covered drugs). Under the legislation, formulary changes can only be made at the time of health plan renewal, if the formulary change is made uniformly across all identical or substantially identical health plans, and if written notice is provided 60 days or more before the change.

Seniors hit hard by high prices

“The high price of prescriptions is having a severe impact on Rhode Islanders, particularly older residents,” said Ruggerio, noting the state’s population is one of the oldest in the nation.  “Many older Rhode Islanders have limited means.” Ruggerio warns, “the pharmaceutical industry is not going to address this on its own, so it’s up to the state and federal governments to take action.”

Maureen Maigret, co-chair, Long Term Care Coordinating Council, observes that with Medicare paying the tab for costly pharmaceuticals, controlling rising drug costs is a federal issue.  “But this is a big issue to address for those with low and moderate incomes under-insured for prescription drugs,” she says.

“I applaud the Senate legislative package aimed at controlling the cost of prescription drugs for Rhode Islanders,” said Maigret, who cites the findings of a Kaiser Family Foundation survey that shows one out of four persons take four or more prescription drugs and more than one-third say that have difficulty taking their medication properly due to cost. “Seniors may fail to get prescriptions filled, resort to pill splitting or skipping doses. Some may end up with costly hospital Emergency Rooms or inpatient visits as health conditions worsen due to the inability to afford their medications, notes Maigret. She called for lawmakers to make necessary prescription drugs affordable for all who need them.”

Maigret says, “It is time to make necessary prescription drugs available for all who need them.”

“AARP Rhode Island is eager to work with both the Senate and the House of Representatives to pass this important legislation designed to lower prescription drug costs,” said AARP State Director Kathleen Connell. “The high cost of drugs leads families – and particularly older Rhode Islanders on fixed and limited incomes – to often make impossible decisions. No one should have to choose between paying rent, providing food for themselves or their family and vital prescription medications that keep them healthy.

“We look forward to working with legislators from across the state to help improve the health and financial stability of everyone by lowering the cost of prescription drugs. We thank Senate President Ruggerio for once again bringing forth this very important legislation,” adds Connell.

Lawmakers are turning their attention to passing the state budget. Even if the Senate passes every bill in the prescription drug affordability package, the lower chamber must pass companion measures for these bills. When passed, Gov. McKee must sign the legislation to become law. Right now, it’s an uphill battle and Rhode Islanders must call on their state lawmakers to get on board to support bills to reduce the high cost of pharmaceuticals. It’s the right thing to do.

What you should know

This meeting will be streamed live online through Capitol TV (http://www.rilegislature.gov/CapTV/Pages/default.aspx).

Written testimony is encouraged and can be submitted prior to 2 p.m. on Thursday, March 18, 2021, in order for it to be provided to the members of the committee at the hearing and to be included in the meeting records.

Herb Weiss, LRI ’12, is a Pawtucket writer covering aging, health care and medical issues.