State Pharmaceutical Assisstance for the Elderly and Disabled: Planning Issues for Program and Non-Program States

The Medicare Catastrophic Coverage Act (MCCA) would have mandated federal assistance for Medicare beneficiaries who have high annual prescription medication costs, High national expenditures for such drugs have encouraged the development of private and state insurance programs to help with these costs. Ten state pharmaceutical assistance programs (SPAPs), designed to help certain elderly, low income, or disabled people, exist for those ineligible for Medicaid or unable to purchase coverage privately. Coordination of state and federal benefits was a consideration for established programs, and programs being planned needed to determine the feasibity of integration of federal assistance. But the enactment and subsequent appeal of the Act affected both planning and policy implications for these SPAPs. All U.S. states and territories were surveyed before the bill's repeal to collect data on the effects of MCCA for those with prescription drug programs and those without. The repeal of the federal program places pressure on the nonprogram states to proceed, perhaps more cautiously, to initiate program; for their own residents, given increasing out-of-pocket and insurance costs, and no federal program.

The Meanings of Work for Older Workers

Several elements influence the meanings of work: the basic psychological processes of aging; the cohort or generation of the worker; the ecology of the work itself; and the larger social context of managing the risks of aging. This article discusses the meaning of work across the lifespan, and then reviews each of these elements to describe the meanings of work for older workers. The authors summarize data from multiple sources to answer several related questions: Why do older workers continue to work—beyond the solely monetary motivation? How do older workers' meanings of work vary by financial, health, job satisfaction, familial, or workplace concerns? What are the implications of these findings for employers and employees?