Why we oppose Ohio Issue 2

On the surface, Issue 2 can sound like a reasonable idea.  It requires Ohio’s state government to contract for prescription drugs at the same prices paid by the U.S. Department of Veterans Affairs (VA). But dig deeper. The proposal is full of flaws and not rooted in the reality of how state government actually obtains medication.

Issue 2 applies only to state programs, the largest being Medicaid. For two out of three Ohioans, Issue 2 will do nothing to lower drug costs and could in fact raise costs and reduce access. Ohioans who use Medicare, or private insurance are left out.

Issue 2 offers no detail critical to its implementation. As a result, it will likely to lead to more bureaucracy, red tape and lawsuits.

Three former Ohio Medicaid directors, and a former state budget director closely examined Issue 2 and concluded it won’t work. Here are some key flaws they identified:

  • The VA purchasing contracts are confidential, the lowest price paid cannot be known for all drugs.
  • The state already negotiates drug purchasing contracts. For the largest program, Medicaid, the state already receives a baseline discount of 23.1 percent, with supplemental discounts and rebates negotiated on top of that. This is extremely close to the VA’s existing baseline discount of 24 percent off drug contracts.
  • The VA distribution system operates very different from state programs. In Medicaid for example, the state reimburses pharmacies for dispensing medication to beneficiaries. The VA system dispenses through mail order and clinics. The associated distribution costs that state government must cover for Medicaid and other programs are not addressed in Issue 2.
  • The VA is designed to serve a military population. Specialty medicines for infants and children are not on a VA formulary and Issue 2 offers no guidance on how to handle those medications.

More than 80 trusted and respected Ohio organizations oppose Issue 2.  Groups representing nurses, doctors, pharmacists, veterans, patient advocates, faith and community groups, as well as business and labor groups carefully studied the issue, many hearing from the proponents too, and concluded Issue 2 is bad public policy.

In addition, Issue 2 has an unprecedented legal provision that requires Ohio taxpayers to pay the legal expenses of the four original petitioners, if they intervene in any litigation that may arise if Issue 2 is not implemented to the satisfaction of the proponents. This is a blank check to the proponents, who do have a history of litigation.

To summarize, Issue 2 will not do what it promise. It applies only to state government, leaving out two of three Ohioans. More than 80 respected Ohio organizations oppose Issue 2. State policy experts say it won’t work. And finally, state taxpayers would be on the hook with a blank check to cover legal challenges from the proponents. Visit www.noonissue2.org for more information and please,  vote NO on Issue 2.