SPRINGFIELD -- Bonita Turley gets emotional when she thinks about the $100 in additional medical expenses she could have to pay each month.

SPRINGFIELD -- Bonita Turley gets emotional when she thinks about the $100 in additional medical expenses she could have to pay each month.

The Buffalo resident is among a chorus of seniors and advocates who hope Gov. Pat Quinn decides not to sign a budget-cutting bill that would eliminate Illinois Cares Rx, a statewide prescription-assistance program for low-income senior citizens and people with disabilities.

“I want to be as independent as I can,” said Turley, 65, a former insurance clerk who takes medicine for diabetes, seizures and thyroid problems.

“Please think of me and the other people who need this,” she said. “I do need the help.”

Quinn nonetheless is expected to approve the measure, part of a package of bills designed to keep Illinois’ Medicaid system from falling further into the red.

Mike Claffey, spokesman for the Illinois Department of Healthcare and Family Services, said eliminating Illinois Cares Rx was “one of a series of tough decisions” needed to preserve Medicaid’s solvency.

“Illinois Cares Rx was fully state funded and received no federal matching funds,” Claffey said. “Without solving the Medicaid crisis this spring, the program would have continued to eat into the state’s ability to fund critical state priorities.”

Illinois is one of 27 states that offer pharmaceutical assistance programs, according to Chicago-based Health & Disability Advocates.

Cutting Illinois Cares Rx is “penny wise and pound foolish” because it will lead to more seniors skimping on their medicine, then needing expensive care in hospitals or nursing homes, according to David Vinkler, associate state director of Illinois AARP.

“You can say you’re doing taxpayers a favor. I’m not sure you are,” Vinkler said.

Illinois Cares Rx, which has existed in one form or another since 1985, serves 145,000 Illinoisans each year and costs state government $72 million. The program served more than 200,000 people and cost $107 million annually before it was downsized in September.

Illinois residents 65 and older, as well as younger people with disabilities, must re-enroll each year in the program. Illinois Cares Rx pays Medicare Part D premiums and reduces co-pays, deductibles and other pharmaceutical costs.

The program’s clients must have incomes below $22,340 a year for a single person and $30,260 for a two-person household.

“They’re not exactly rolling in cash,” Vinkler said.

Struggle to pay bills

Turley, who lives alone, takes seven to 10 prescription drugs Illinois Cares Rx reduces her Medicare Part D co-pay to as low as $5 per prescription. It also pays her monthly $35 Part D premium.

Even with those benefits, Turley said she struggles to pay her bills with monthly Social Security Disability payments and a modest pension.

Without Illinois Cares Rx, she said, “I wouldn’t be able to take my medicine.”

She thought a moment and said she “would just have to figure a way to cut other things. By the time I pay my monthly bills, groceries and my monthly medicine, it’s just hard.”

Upset seniors have begun to call Senior Services of Central Illinois, 701 W. Mason St.

“They’re wanting to know how they’re going to get their prescription drugs,” said Beth Monnat, Senior Services’ pharmaceutical assistance specialist. Some people have told her they wonder whether they will have to choose between buying food or medicine, she said.

Other federal programs

Quinn administration officials note that some states dropped their pharmaceutical assistance programs after Medicare Part D began in 2006. They also said the federal Affordable Care Act is providing more assistance for drug costs by gradually closing Part D’s “doughnut hole.”

And state officials say a federal program called Extra Help provides extra assistance for low-income seniors.

However, John Coburn, a senior policy attorney at Chicago-based Health & Disability Advocates, said Illinois Cares Rx covers expenses not covered by Medicare Part D.

The doughnut hole’s coverage gap won’t be eliminated until 2020, he said, and most of the people in Illinois Cares Rx have too much income and assets to automatically qualify for Extra Help.

If Quinn signs off on the program’s elimination, Coburn said he hopes the shutdown can be delayed until advocates can counsel more seniors about their options.

Monnat said she is particularly concerned about Illinois Cares Rx clients with asthma or diabetes. Many pharmaceutical companies have charity programs providing free medicines, but insulin and inhalers typically aren’t part of those programs, she said.

Floyd Baker, 84, a retired auto mechanic who lives in Springfield, gives himself daily insulin injections for diabetes. He worries that his $15 co-pay for each of the three insulin bottles he goes through a month will rise significantly — along with his other drug costs — if Illinois Cares Rx goes away.

“I’ll just have to skimp on other things,” Baker said.

The potential end of the program has made him more frustrated with the state’s politicians.

“It doesn’t make sense to me,” he said. “They blow money on everything else. Older people need help because we’re on a fixed income.”

Dean Olsen can be reached at (217) 788-1543. Follow him at twitter.com/deanolsen.


Community Care to tighten eligibility

An estimated 7,000 people 60 and older would fail to qualify for the Community Care program in the next fiscal year, saving the state $26 million a year, based on a bill heading to Gov. Pat Quinn’s desk that tightens the program’s eligibility standards.

“We have to make sure we’re serving the people we really need to be serving,” said Mary Killough, deputy director of the Illinois Department on Aging.

About 80,000 low-income Illinoisans 60 and older — including 1,100 in Sangamon County — are enrolled in the $753 million program, which includes both day services and in-home services such as help with laundry, cleaning and grocery shopping.

The program helps people remain independent and avoid having to move to a nursing home.

Killough said enrollment has grown 14 percent over the past year, compared with growth of 7 to 9 percent in previous years.

The eligibility change would require a higher level of impairment and a weaker support system before a person would be accepted.

Killough said people truly in need of services wouldn’t be denied admission. But David Vinkler, associate state director of Illinois AARP, said the projected savings could be erased if the eligibility change results in some people being denied services and then having to enter nursing homes, where the care is more expensive, but is covered by Medicaid.

More information

More information about Illinois Cares Rx and other government programs for seniors is available through Illinois’ Senior HelpLine at (800) 252-8966. 

Illinois Cares Rx enrollment

County Enrollment

Cass  521

Christian 1,033

Greene 622

Jersey  583

Logan  646

Macoupin 1,323

Mason 173

Menard 255

Montgomery 1,083

Morgan 1,140

Sangamon 3,664

Schuyler 229

Scott  141

Source: Illinois Department on Aging

Community Care enrollment

County Enrollment

Cass  114

Christian 181

Greene 122

Jersey  113

Logan  153

Macoupin 289

Mason 135

Menard 66

Montgomery 160

Morgan 221

Sangamon 1,096

Schuyler 39

Scott  28

Source: Illinois Department on Aging