As a pharmacist, I know people are concerned with being able to afford their medicine. I also know that things that sound too good to be true usually are, and that’s certainly the case with Issue 2.
Proponents claim that Issue 2 will save taxpayers millions of dollars and make prescription drugs cheaper. But experts who have studied the issue — including a former state budget director and three former Ohio Medicaid directors who served in both Democratic and Republican administrations — say it is likely to do the exact opposite, raising drug costs for the majority of Ohioans and reducing access to needed medicines for some of our most vulnerable citizens.
Eighty trusted statewide organizations—representing veterans, business, organized labor and more than 30,000 Ohio doctors, nurses, pharmacists and hospitals—agree. And as a community pharmacist in northwest Ohio for over 35 years, as well as a current board trustee for the Ohio Pharmacists Association, I was proud to have my organization join the growing coalition that opposes this misguided ballot initiative.
So, what’s wrong with Issue 2, and why would it be bad for you and your family?
First, most Ohioans aren’t included. Since it would only apply to prescription drugs purchased by Ohio’s state government agencies and entities, nearly two-thirds of our population would be left out, including those with private insurance, employer-provided insurance and seniors who rely on Medicare. But, if you’re among the two out of every three Ohioans who don’t get prescription drugs through state programs, cost-shifting could and probably would make your costs increase.
Second, Issue 2 won’t save money for taxpayers. Proponents imply that while the VA receives a 24 percent federally mandated discount on the drugs it purchases, Ohio pays full price. Nothing could be further from the truth. Medicaid, which accounts for three-quarters of the drugs our state government buys, receives a 23.1 percent federally mandated discount and also receives additional, voluntary discounts that the state negotiates with drug makers. The bottom line—confirmed by three former Ohio Medicaid directors—is that the VA and the state of Ohio currently receive roughly the same discount off the average manufacturer’s price.
Third, Issue 2 could mean reduced access for those who do obtain their medicines through state programs, which along with Medicaid recipients, include state employees and retirees, as well as public college and university personnel. By prohibiting the state from paying more than the VA pays for each individual drug, Issue 2 would tie the drugs Ohio purchases to the relatively narrow VA formulary that is primarily designed to treat military veterans. But, because many Medicaid recipients, for example, are low-income women, children and infants, Ohio buys many drugs that the VA doesn’t. It’s unclear whether Ohio could continue buying those drugs if Issue 2 passes and, if it could, at what price. In other words, the same population Issue 2 is ostensibly designed to help could face reduced access to needed medications. This is extremely reckless.
Fourth, Issue 2 would usher in a bureaucratic nightmare of epic proportions. Because it lacks any direction or language guiding implementation—and because the controversial California health care CEO who paid to put it on our November ballot refused to consult with any Ohio health care experts or officials who would be tasked with its implementation — the result would almost certainly be a morass of delays, bureaucratic in-fighting and law suits, all of which would mean higher costs for taxpayers.
Fifth, speaking of higher costs for taxpayers, Issue 2 gives the four sponsors who circulated the petition that got the initiative on the ballot an unprecedented right to defend any legal challenges to the law and, incredibly, requires Ohio taxpayers to pay their attorney fees, whether they win or lose. With no cap on the fees taxpayers would be required to cover, this amounts to a “blank check.” This is especially problematic because three of those four sponsors work for the California CEO whose organization is funding the ballot issue and who has already filed 52 lawsuits against government agencies in seven different states, including three in Ohio.
For all these reasons and more, the Ohio Pharmacists Association and 80 other statewide organizations have come together to sound the alarm and urge all Ohioans to vote “no” on Issue 2. It won’t do what it promises, and it’s bad public policy that threatens to make the problem of affordable drugs even worse. In our view, Issue 2 is nothing less than a prescription for disaster.
Deb Randall, a graduate of the University of Toledo College of Pharmacy, is a pharmacist at Grund Drug in Fremont and a district board trustee of the Ohio Pharmacists Association.