Can't Make the Grade - Access to Medications Update

Restricting Access to Medications: A Silver Bullet?
As states confront budget shortfalls of more than $80 billion in the coming fiscal year, almost every state has considered restricting access to medications in its Medicaid program.

In fact, Can’t Make the Grade: NMHA’s State Mental Health Assessment found that by early 2003, over half of the states had restricted access to medications in either law or regulation. Although increasing numbers of states are exempting mental health medications in some way, many of these exemptions are limited to one class of medications and are ultimately only a partial solution.

In the short time since this publication has gone to press, several states have made changes to their state Medicaid programs and the policies regulating access to medications. Already the number of states restricting access to medications has moved above 30, and other states are continuing to look to prescription drug restrictions as a solution to the Medicaid budget crisis. Since Can’t Make the Grade has gone to press:

• Fifteen states have passed legislation to establish a preferred drug list.
• Twelve additional states have specifically exempted mental health medications in some way from their preferred drug list (AL, CO, IA, LA, MD, MS, NM, NC, OK, NV, TN, SC
• Four states have not exempted mental health medications (IL, MA, ND, SD, TX)

Several other states are still in legislative session and are considering legislation or regulations that will restrict access to medications. Proposals to exempt mental health medications or eliminate current exemptions are on the table in many of these states. States to watch include: Ohio, Rhode Island, New Jersey, Virginia and Tennessee.

For more information, please contact NMHA’s Advocacy Resource Center at 800-969-NMHA (6642), Option 6.

This project was made possible by the generous funding of the W. K. Kellogg Foundation in collaboration with the Community Voices: Healthcare for the Underserved initiative (www.communityvoices.org).

National Mental Health Association
2000 N. Beauregard Street, 6th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959