In Anchorage, a 24-year-old Zumba instructor recently guided dozens of local residents through a grueling workout. Nothing was out of the ordinary, aside from one small detail — instructor Yulissa Arescurenaga has Down syndrome.
Yulissa doesn’t let Down syndrome stop her from helping Alaskans live healthier. Thankfully, state officials are repaying the favor. Alaska just established the Alaska ABLE program, which helps all Alaskans with disabilities save up for their own futures.
Unfortunately, just as Alaska state officials are improving lives through the new Alaska ABLE program, federal officials are poised to make significant life-threatening changes to Medicare. Unless Alaska’s representatives scuttle the changes, tens of thousands of Alaskan seniors and people with disabilities could lose access to affordable prescriptions.
An unusually high share of Alaskans live with a disability. About 11 percent of Alaska’s population has at least one. And one of every 580 babies born in Alaska has Down syndrome, compared to a national average of one in every 700.
The costs of having a disability are staggering. In the United States, spending on disabilities accounts for more than a quarter of health care spending. Medical costs for young children with Down syndrome are about 12 times higher than for children without Down syndrome.
These costs can send any family into financial ruin. In fact, 40 percent of the families of children with Down syndrome report financial difficulties.
Previously, these costs were even more burdensome because people with disabilities and their families were virtually prohibited from saving up for healthcare expenses in a rainy day fund. If they saved more than $2,000, they’d lose eligibility for government disability and healthcare benefits.
Thanks to the Alaska ABLE program, these families can now save up to $100,000 of their own money in tax-free accounts without jeopardizing SSI, and beyond that limit with never losing Medicaid. Alaska ABLE allows the individuals with a disability to invest the funds in a 529A, and use the account to pay for their health care, transportation, education, and housing expenses.
Unfortunately, Alaskans with disabilities now face a new threat — changes to Medicare Part D. Part D provides affordable prescription drug coverage to those with disabilities, just as it does for seniors.
Medicare Part D is a government program based on market principles. This competition keeps premiums and deductibles in check.
That structure has worked remarkably well, giving Medicare enrollees their choice of drug plans. In 2017, Alaskans have access to 18 different Part D plans, one of which has a premium of just $17 a month.
In addition to competitive pressure amongst insurers, plans are relatively inexpensive because insurers haggle with drug companies for sizeable discounts — 35 percent, on average.
Some lawmakers in Congress think those discounts aren’t enough. To gain bigger rebates, they want federal officials to step in and negotiate prices on behalf of all insurers participating in Part D.
According to the nonpartisan Congressional Budget Office, the government wouldn’t be able to secure lower prices through negotiation than private insurers already do. To keep its promise of slashed prices, the government might ration care or just flat out refuse to cover certain medications.
Doing so could spell disaster for patients — especially senior citizens and people with disabilities.
Alaska ABLE and Medicare Part D work because they both rely on consumer choice. Alaska ABLE allows individuals and families to provide for their own future. Similarly, Medicare Part D beneficiaries are allowed to shop around for the best plan for them while putting pressure on insurers to keep prices affordable.
With the Alaska ABLE program, officials made sure that individuals with Down syndrome and other disabilities can afford necessary expenses related to the disability. It’d be a travesty if Congress undermines that progress removing by that consumer choice in Medicare.
• Sara Hart Weir is the President of the National Down Syndrome Society. She lives in Washington, D.C.
