States Cut Medicaid Drug Benefits To Save Money

By Phil Galewitz

Illinois Medicaid recipients have been limited to four prescription drugs as the state becomes the latest to cap how many medicines it will cover in the state-federal health insurance program for the poor.

Doctors fear the state's cost-cutting move could backfire on patients, who have to get state permission to go beyond the limit.

"We understand the state is trying to get its Medicaid budget under control," says Dr. William Werner, president of the Illinois State Medical Society. "But our concern is it not be a hardship for patients and a hassle for doctors in the execution."

Sixteen states impose a monthly limit on the number of drugs Medicaid recipients can receive and seven states have either enacted such caps or tightened them in the past two years, according to the Kaiser Family Foundation (KHN is a program of the foundation). The limits vary across the country. Mississippi has a limit of two brand-name drugs. In Arkansas adults are limited to up six drugs a month.

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