peel back effect

State coverage of Viagra and Cialis under debate

Matt Bittle
Posted 4/27/15

DOVER — Members of the State Employee Benefits Committee gathered Monday to once again discuss proposed health-care increases for Delaware government workers, and once again, no vote was conducted. …

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State coverage of Viagra and Cialis under debate

Posted

DOVER — Members of the State Employee Benefits Committee gathered Monday to once again discuss proposed health-care increases for Delaware government workers, and once again, no vote was conducted.

The high-stakes topic continues to be discussed and debated as panelists look to eliminate a $60.1 million shortfall.

Co-pays, deductibles, premiums — all sorts of things are on the table.

Among the items being scrutinized is eliminating payment for erectile dysfunction drugs for state workers. At $2.7 million per year, it’s more of a minor item, meaning cutting Viagra and Cialis still would leave Delaware in a hole. But it is one of the options the committee could choose.

Under the current coverage for state employees, those seeking erectile dysfunction treatment can receive six pills per month for a cost of $45. (www.bing.com)

About 3,400 individuals covered by taxpayer-funded state insurance utilize erectile dysfunction drugs. Under the current plan, members receive six pills per month for a cost of $45. One option would have the state limiting the number of pills to four per month. A separate proposal would bump the cost up to $48 or $50 every month.

Cutting the number of pills by one-third would save $900,000.

The second option is to eliminate such coverage entirely, saving $2.7 million. Consumers could pay anywhere from $33 to $80 per pill out-of-pocket, according to Brenda Lakeman, director of the Statewide Benefits Office in the Office of Management and Budget.

The SEBC also could opt to leave the coverage area alone.

Few private insurance plans cover Viagra and Cialis, though a number of states do provide them for employees, Ms. Lakeman said. They are not covered by Medicaid.

The SEBC’s union representative said afterward while he does not feel particularly strongly about the specific issue, he supports simply reducing the number of pills rather than cutting coverage altogether.

“I think that’s a more prudent option,” said Geoff Klopp, president of the Correctional Officers Association of Delaware.

During the meeting, Treasurer Kenneth Simpler questioned eliminating coverage without seeing more information on how many states include Viagra and Cialis costs. Ms. Lakeman said she has heard a small number of concerns and complaints from workers about cutting the drugs.

Office of Management and Budget Director Ann Visalli, the committee chairwoman, observed the general consensus seemed to be against eliminating erectile dysfunction treatments.

While no vote was taken on how to stamp out the deficit, members agreed to develop their own priority list in the ensuing two weeks. The committee convenes again on May 11, and a vote could be taken then.

With the Legislature’s Joint Finance Committee set to resume work on the budget in three weeks, the clock is ticking.

Mr. Klopp said he is afraid the state will balance the budget “on the backs of state employees and retirees.” If the committee votes to make only minor changes to health-care costs, it would need the JFC to provide several million dollars from the General Fund.

It also is likely that doing so would be a short-term fix.

“The general narrative here is we don’t have money,” Mr. Simpler said.

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