On a rainy summer morning in 1999, a group of older Mainers boarded a chartered bus in Portland, headed for Quebec on an unusual shopping trip. At a Montreal drugstore, they purchased essential prescriptions for a fraction of their cost in Maine. This was not the first, nor would it be the last such expedition. What made this trip more extraordinary was that Mike Wallace and a “60 Minutes” news crew came along to cover it. Activism by older Mainers, beginning a quarter century ago, blazed the trail for key health care provisions in President Biden’s historic Inflation Reduction Act that expand coverage and affordability for millions of Americans, including tens of thousands of Mainers.

The new law extends assistance for lower insurance premiums to about 59,000 Maine residents covered through the Affordable Care Act. The bill also caps out-of-pocket prescription drug expenditures for Medicare beneficiaries at $2,000 per year. At long last, the new law also allows Medicare to negotiate lower prices for prescription medications, one of the common-sense cost-cutting measures those bus-riders advocated.

Historically, pharmaceutical manufacturers have negotiated lower prices with big customers that buy in bulk – insurance companies, managed care organizations, state Medicaid programs and even certain federal agencies like the Veterans Affairs Department. For decades, these companies, through PhRMA, their powerful lobby, have spent hundreds of millions from their billions in profits, to deny the same bargaining tool to their biggest customer, Medicare.

In February 1998, at a Sanford constituent forum on Medicare and Social Security, Leon Currier, a retired firefighter, urged then-freshman U.S. Rep. Tom Allen to focus on soaring drug prices. Currier’s doctor had prescribed a medication costing $100 a month, so expensive that he decided not to take it. The next day, Allen directed his staff to investigate options and recommend actions to provide relief to Currier and millions of older Americans struggling to pay for needed medications.

As a member of the House Committee on Government Reform, Allen shared his concerns with ranking member Henry Waxman. Committee staff offered to conduct a study comparing over-the-counter prices older Mainers in the 1st Congressional District paid for their drugs with those pharmaceutical companies negotiated with “favored customers.”

Released in July 1998, the study found that older Mainers paid, on average, more than twice as much for their medications. Subsequently, House members from districts all over the nation commissioned studies based on the Allen model with similar results. Additional further studies – comparing prices uninsured Mainers paid for medications with prices in Canada and Mexico – confirmed that prices in both were a fraction of what Mainers paid.

On Sept. 28, 1998, Allen introduced the Prescription Drug Fairness for Seniors Act, the first legislation to empower Medicare to negotiate lower prescription drug prices for Medicare recipients. Massachusetts Sen. Ted Kennedy subsequently introduced the bill in the Senate. Republican House leaders refused to hold hearings or allow a vote on the bill. Allen reintroduced the bill in subsequent sessions, eventually enlisting 153 co-sponsors.

Meanwhile, stories from older Mainers continued to pour in, not only to Allen but also to other Maine federal and state lawmakers. One wrote: “I don’t want my husband to know, but I’ve stopped taking my medication so that we can afford his.” Another wrote, “I’ve been cutting my pills in half so that they can last longer before I need to pay for another prescription.”

Viola “Vi” Quirion, a retired factory worker in Waterville, spent a quarter of her $900-per-month income on medications to treat arthritis, a stomach condition and, ultimately, cancer. Despite her significant health challenges, she became a dedicated activist and spokesperson. She was a passenger on that 1999 bus trip. She shared her story with Mike Wallace and millions of viewers nationwide. Quirion also traveled to Washington for a news conference with Rep. Allen to rally support for his bill.

John Marvin had organized that bus trip as regional director of the National Council of Senior Citizens. He later worked with Chellie Pingree, then a state senator from North Haven, on state-level price negotiation legislation. PhRMA challenged Pingree’s Maine Rx legislation all the way to the U.S. Supreme Court, which ultimately ruled in Maine’s favor. Pingree later succeeded Allen as 1st District U.S. representative. Grateful older Mainers dedicated a wing of an Augusta senior living residence in Marvin’s memory.

PhRMA continued to block Medicare price negotiation from both the 2006 legislation establishing Part D prescription drug insurance for Medicare recipients and the 2010 Affordable Care Act.

President Biden’s Inflation Reduction Act, supported by Maine Reps. Pingree and Jared Golden and Sen. Angus King, finally routed PhRMA’s crusade against price negotiation. As a result, both Medicare recipients and U.S. taxpayers will realize annual savings in the hundreds of millions of dollars.

As we celebrate this legislation, remember Leon Currier, Vi Quirion, John Marvin and so many other outspoken older Mainers whose activism helped pave the way to this epic achievement. And let us follow their example as we continue to expand coverage and reduce health care costs for all Americans.

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