COLUMBIA --- South Carolina senators chipped away Wednesday at spending on the state's Medicaid program, approving budget measures that will make it tougher for patients with mental illness or HIV/AIDS to get name-brand drugs.
The $5.8 billion spending plan the Senate is considering for the fiscal year that begins July 1 includes more than $1 billion for Medicaid programs.
Budget writers had approved making sure patients with mental illness or HIV/AIDS could continue getting name-brand drugs if they were stable on them. But a handful of senators said it was a waste of money to allow free access to the more expensive drugs without first trying generics.
State Sen. Kevin Bryant, an Anderson pharmacist and Republican, said he's seen no generic drug that didn't perform as well as its name-brand counterpart. "It just bothers me in the drug store to see the taxpayers' money -- Medicaid dollars -- going to waste," Bryant said.
State Sen. David Thomas argued the state is wasting hundreds of millions of dollars on brand-name drugs. "We want to have generic where possible," said Thomas, a Fountain Inn Republican.
The shift to generics for those patients would yield savings of $991,000, said Jeff Stensland, the spokesman for the Department of Health and Human Services. Stensland said the savings could be much larger in subsequent years as generic alternatives become available for more drugs.
Health and Human Services Director Tony Keck said his policy is to maintain stability for patients. That includes approving name-brand drugs when appropriate.
"The whole idea is to save the department money while getting the best results. We don't want to do anything if a patient's on a stable drug that makes them unstable," Keck said. "When someone decompresses and loses stability, that ends up costing us many, many times more than the drug costs because they end up in the emergency room, they end up in psychiatric admissions, and in terms of cancer, they end up with allergic reactions. There are all sorts of things that cost us money."
The Senate also agreed to limit how insurance companies spend Medicaid money. Senate President Pro Tem Glenn McConnell won approval for a measure that bars them from being reimbursed by Medicaid for hiring lobbyists.
And the Senate nixed a budget provision that required coverage for chiropractic services.
Lt. Gov. Ken Ard ruled more than a dozen budget items out of order because they changed permanent law in violation of Senate rules.
His list included adding a year to current two-year child care facility licenses. Supporters said it would reduce paperwork. However, it would have also meant food safety inspections tied to license renewals would have happened every three years instead of every two.
Meanwhile, Senators rejected plans to increase monthly health insurance premiums for state workers by $5.
Sen. Greg Ryberg, an Aiken Republican, said state workers should split the cost of higher premiums with the state. He argued plenty of people without state jobs are paying 100 percent of their premiums and that taxpayers shouldn't foot all of the bill.
Sen. Thomas Alexander, a Walhalla Republican, said state employees already are facing a $6 increase in premiums. And senators note state workers haven't seen a general pay increase in four years.
Ryberg's proposal failed with a 24-16 vote.