You asked for (1) details on the Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled (ConnPACE) program, (2) how many seniors are enrolled in the program, and (3) how many other states have similar programs and which of them are doing a more comprehensive job of assisting their seniors with prescription drugs than Connecticut.

SUMMARY

ConnPACE helps Connecticut's seniors and younger disabled people pay for prescription drugs. Income limits are $ 20,000 annually for single people and $ 27,100 for married couples, adjusted annually for inflation. The program requires a $ 25 annual registration fee and per-prescription copays of $ 12 or $ 15 depending on participants' application date and income level. There is no annual deductible, no limit on benefits, and no asset test. The program had about 48,500 enrollees at the end of September 2002, of which almost 42,000 were seniors.

Eight of the 26 states that have programs similar to ConnPACE could be seen as more comprehensive because their income limits are higher than Connecticut's current limits. These include Illinois, Maryland, Massachusetts, New Jersey, New York, Rhode Island, Vermont, and Wisconsin. But some of these programs also have copays, annual fees, premiums, deductibles, and limits on kinds of drugs, which are actually

less favorable to the beneficiary than ConnPACE. On the other hand, if federal agencies approve Connecticut's request for a federal waiver, the ConnPACE income limits could increase further.

CONNPACE

Program Description

ConnPACE pays for prescription drugs, insulin, and insulin syringes and needles for people at least age 65, as well as younger disabled people. Applicants' annual income currently is capped at $ 20,000, if single, and $ 27,100 if part of a married couple. This limit is adjusted annually to reflect inflation adjustments in Social Security payments. Participants must be state residents for at least six months and pay an annual $ 25 registration fee and a copayment for each prescription. The copayments are currently (1) $ 12 for people enrolled in the program before September 1, 2002 and for those enrolled after that date whose incomes are below $ 15,900 for singles and $ 21,500 for married couples and (2) $ 15 for those who first enroll in the program after September 1, 2002, and have incomes between $ 15,900 and $ 20,000 for singles and between $ 21,500 and $ 27,100 for married couples. Certain prescriptions are not covered, such as antihistamines and diet pills.

As a result of 2001 legislation, the Department of Social Services (DSS) has requested a federal Medicaid waiver that, if approved, would increase the income caps to 300% of federal poverty level and turn the exclusively state-funded ConnPACE program into a Medicaid waiver program with federal financial participation. (For 2002, 300% of the federal poverty level is $ 26,580 for a one-person household and $ 35, 820 for a two-person household). So far, however, the federal government has not given its approval for the change.

Additional information on ConnPACE and how to apply is available at the DSS ConnPACE website: http: //www. connpace. com/. We have enclosed a copy of the ConnPACE brochure, which can also be found at:

http: //www. connpace. com/pubs/connpace_brochure_en. pdf

Enrollments and Program Operation

ConnPACE had 48,524 enrollees as of September 30, 2002. Of these, 41,936 (86%) were over age 65 and 6,589 (14%) were younger people with disabilities. Additional details on enrollments and other aspects of the program's operation are available in the latest ConnPACE Quarterly Report (July 1 to September 30, 2002), enclosed, at

http: //www. connpace. com/pubs/Quarterly. pdf

OTHER STATES' PROGRAMS COMPARED TO CONNPACE

At least 34 states have established or authorized some type of program to provide pharmaceutical coverage or assistance to low-income elderly or persons with disabilities who do not qualify for Medicaid, either through a direct subsidy, a discount, insurance, or some type of bulk purchasing program, according to the National Conference of State Legislatures (NCSL).

Of these, 26 states offer a direct subsidy using state funds. These states are Arizona, Arkansas, Connecticut, Delaware, Florida, Illinois, Indiana, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, Nevada, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Vermont, Wisconsin, and Wyoming. Most of these states, however have income limits below Connecticut's. Some also have higher copays, require substantial annual deductibles or monthly premium payments, or limit the annual amount the state will pay. Extensive information on these programs is available on the National Conference of State Legislatures (NCSL) website at http: //www. ncsl. org/programs/health/drugaid. htm

Table 1 below compares the most important features of Connecticut's program with the eight states that have higher income caps than Connecticut's current limits. These programs also vary in the items they cover, copays, deductibles and other fees.

A number of states have several types of programs or have incorporated their lower income programs that provide more benefits as one level of the overall program with higher income limits.

Table 1: Comparison of ConnPACE and Other States

with Higher Income Caps

Table 1: Comparison of ConnPACE and Other States

with Higher Income Caps

-Continued-

Source: NCSL website (supplemented by our own research)

*Illinois' program is limited to drugs for specified chronic diseases (newer expanded Medicaid waiver program (Senior Rx) covers most drug, but only up to 200% of FPL, a limit lower than ConnPACE's)

**Maryland has another program that provides more coverage for people at income levels than ConnPACE

***This Vermont program is VSCRIPT Expanded. Vermont has other programs with lower income caps than ConnPACE.

**** Wisconsin also has option for people above these limits to "spend down" on drugs until they are eligible.

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