Starting today, thousands of elderly Marylanders can get some help paying for the pricey prescription drugs they need to stay healthy and active.
With Congress still debating how to help senior citizens nationwide, a new Maryland law requires the state's largest HMO to offer prescription drug insurance to as many as 15,000 elderly residents in 17 rural counties.
The insurance - provided through CareFirst BlueCross BlueShield - is expected to be of limited help, however, especially for people on fixed incomes taking multiple medications for chronic conditions such as heart disease, diabetes and arthritis.
"It's totally a stopgap," acknowledged Del. Ronald A. Guns, a Cecil County Democrat involved in crafting the drug-insurance law.
He said state lawmakers didn't want to wait for Congress to help Maryland's rural elderly, who were stranded last year when CareFirst canceled its Medicare plans covering pharmacy costs.
The drug plan for rural seniors is one of 196 state laws that take effect today.
Among the more significant is a change in the collection of property taxes, which officials say could result in one-time rebates of $600 or more for more than 900,000 homeowners statewide.
Other new laws partially repeal the state's inheritance tax, raise the tax on sales of cigars and other noncigarette tobacco products and eliminate the tax on purchases of energy-saving washing machines and smoking-cessation aids such as nicotine gum.
The drug-insurance law is controversial among the elderly and their advocates.
They say the coverage is too costly and too limited.
Eligible participants will have to pay $480 a year in premiums and chip in $10 to $35 a prescription, depending on the medication. CareFirst will cover up to $1,000 a year in drug costs.
Once subscribers exceed that cap, they can buy medication through the plan at discounts of 13 percent to 16 percent off the prescription cost.
"That wouldn't help me too much," said Loudie Schuck, 64, a retired motel employee in Hagerstown.
She lives on $963 a month from Social Security, and estimates spending $500 on medication every month to control her diabetes, lupus, eye and heart problems.
Food or medication
CareFirst said it canceled its Medicare drug coverage in rural areas because it was losing money.
Since the HMO dropped her last year, Schuck said she has appealed to her doctors and to the Washington County Health Department to try to get free or discounted medicine whenever she can.
"But there are some seniors who can't do what I do," she said. "They're choosing between food and medication, and that's not right, living in America."
Only 455 people had enrolled in the prescription drug program by yesterday, said Debbie Rosen McKerrow, a CareFirst spokeswoman. She noted that the company mailed letters last week to 13,100 rural seniors believed to be eligible for the program.
'Better than nothing'
While the plan won't do very much for people taking several expensive medications, it could lighten the burden for those with more modest drug bills of $150 to $300 a month, said Jennifer Hockman, who works in Allegany County's Office on Aging.
"It's better than nothing for some folks," she said.
'Subsidizing the insurers'
Other advocates contend that legislators bear some responsibility for the plan's flaws.
"They're subsidizing the insurers," said Charlie Gerhardt, president of the Maryland Patient Advocacy Group.
In return for providing rural seniors with drug coverage, CareFirst BlueCross BlueShield was allowed keep a state-provided 4 percent discount on the rates it pays to hospitalize its subscribers.
Lawmakers had threatened to curtail the discount, estimated to be worth $40 million a year to CareFirst, because they did not believe the HMO was doing enough to offer affordable health plans to uninsured Marylanders.
The rural seniors' drug plan is expected to cost $5.4 million, with CareFirst paying $4.4 million and three other health maintenance organizations providing the rest.
If more people sign up than expected, said CareFirst's spokeswoman, the HMO will cover the extra cost.
Guns acknowledged the plan's limitations, but argued that the ultimate remedy to a national problem must come from Congress. The Republican-controlled House of Representatives this week narrowly approved a $40 billion plan to help older Americans buy private prescription drug insurance, sending it to the Senate. Many Democrats advocate setting up a more generous and costly program through Medicare.
New laws in Maryland
Here are some of the new state laws that take effect in Maryland today:
Inheritance tax: Money or property left to certain relatives - a spouse, children, parents, siblings or other lineal descendants - will no longer be subject to the state tax.
Sales tax: Nicotine gum, patches and other smoking cessation products and certain energy efficient appliances are now exempt from the state's 5 percent sales tax. To determine which appliances qualify, call the U.S. Environmental Protection Agency at 1-888-STAR-YES or visit the EPA's Web site atwww.energystar.gov.
Lead screening: All 1- and 2-year-olds in Baltimore and in other as-yet undesignated high-risk areas must be screened for possible lead poisoning.
Hemp: Police-supervised pilot project to grow and market industrial hemp, a relative of marijuana, is authorized. This variety is thought by some to be a possible alternate crop for Maryland's tobacco farmers.
Slavery panel: A state commission is established to develop and disseminate information about the history and legacy of slavery in Maryland.