Poor Coverage: Examining the Switch in Prescription Drug Insurance for Dual Eligibles from Medicaid to Medicare Part D

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2014
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Haverford College. Department of Political Science
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Thesis
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Award
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eng
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Open Access
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Abstract
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 forced individuals who qualify for Medicare and Medicaid, known as dual eligibles, to shift their prescription drug insurance coverage from Medicaid to Medicare Part D. Under Medicaid, dual eligibles received expansive coverage. Medicare Part D, however, presented several problems for dual eligibles, including less expansive drug formularies, higher copayments, and a difficult to navigate market where dual eligibles selected their insurance plans. This thesis evaluates the role of the National Governors Association (NGA) and state budgets in influencing the outcome of the switch in coverage for dual eligibles. While the NGA convinced members of Congress to place the dual eligible issue at the top of the congressional agenda and shaped congressional discourse, not enough evidence exists to suggest a direct correlation between NGA lobbying efforts and the outcome of the bill. State budgets had little direct impact, but likely influenced the opinions of Maine's senators. I conclude that party politics likely had the most influence on congressional opinions.
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