Medicaid/SCHIP: Prescription Drugs
Medicaid is currently the largest public payor for prescription drugs, and it is an important source of drug coverage for the low-income elderly, including nearly 6 million Medicare beneficiaries, and people with disabilities. While constituting roughly a quarter of Medicaid enrollment, these two populations account for approximately 80% of the program’s drug spending. Prescription drugs have been an important driver of Medicaid spending growth for the last several years, prompting heightened state efforts to control drug utilization and costs. However, the greater need for prescription drugs and financial vulnerability found within the Medicaid population means that efforts to control spending must be balanced against maintaining beneficiaries’ access to needed therapies.