Aetna drops Walgreens from its Medicaid plan, making it harder for low-income Chicagoans to get their prescriptions during the pandemic
A patient had a severe mental illness, but with monthly injections of medication, he stopped hearing voices and was able to live in subsidized housing, according to Dr. Thomas Huggett, of the Lawndale Christian Health Center.
Then came the Aetna insurance company’s decision to drop Walgreens from the patient’s Medicaid plan.
Instead of walking a few blocks to pick up his medication at a neighborhood pharmacy, the patient has to set out on a 3-mile bus trip to the closest CVS, at 26th Street and Pulaski Road.
“It’s one more thing for someone with a severe mental illness to have to go through to get his medication,” Huggett said.
Huggett’s patient is one of about 400,000 Illinois Medicaid members affected by Aetna’s decision to exclude the Walgreens chain from its Aetna Better Health of Illinois pharmacy network, effective Dec. 1.
Critics say the decision is hitting poor and majority-Black neighborhoods on the South and West sides hard at a time when residents are already disproportionately suffering from COVID-19 and unemployment.
“It’s really pathetic,” state Rep. La Shawn Ford, D-Chicago, said of Aetna’s decision. “It’s an attack not just on Black people, but on those that are struggling during the pandemic.”
In a written statement, Aetna responded that it has nearly 2,000 in-network pharmacies statewide for Medicaid members, including independent pharmacies and those in national and regional chains such as Walmart and Jewel-Osco.
“The removal of one pharmacy chain from the network earlier this month has not created or contributed to network access issues and we meet or exceed all of the state’s access requirements for managed care organizations,” the statement from Aetna said. “In fact, the Illinois Department of Healthcare and Family Services has reviewed our updated network and determined it ensures equity.”
Aetna has 271 in-network pharmacies for Medicaid patients in Chicago alone, according to the insurance company.
But many of those in-network options are small, independent pharmacies that don’t offer the hours, conveniences and large stock of readily available medications that make life easier for people with serious medical conditions, such as diabetes, opioid addiction and mental illness, Huggett said.
“The problem is many small, independent pharmacies are just that: They’re small,” said Huggett, a family physician who has practiced on the West Side for 25 years.
He compared the suggestion that his patients go to small pharmacies for their medication needs to the notion that people living in food deserts (without big grocery stores) can find sufficient fresh produce at neighborhood convenience stores.
CVS, which owns Aetna, has no pharmacies in five key West Side neighborhoods: North Lawndale, East Garfield Park, West Garfield Park, Humboldt Park and Austin.
In 2018, the Tribune reported that pharmacy access was a growing health concern in Chicago, with some public health experts saying that more than a dozen low-income neighborhoods, mostly on the South and West sides, were becoming “pharmacy deserts.”
“A lot of public attention focuses on insurance, but that’s not enough,” said Dima Qato, an assistant professor in the department of pharmacy systems, outcomes and policy at the University of Illinois at Chicago. “Even if medications are affordable, if the pharmacy isn’t accessible, they’re not accessible.”
Huggett’s patient with a severe mental illness made it to the Pulaski CVS and back; he’s strongly motivated, Huggett said, and unlike many of Huggett’s patients, he’s able to scrape together bus fare.
Huggett said that with a 55% increase in opioid-related overdose deaths in Chicago in the first part of 2020, compared with the same period last year, access to maintenance medications that keep people off street drugs is more vital than ever.
And with plans for the COVID-19 vaccine to be distributed at pharmacies, he has concerns for the future as well.
“I’m fearing that people will not have access to the coronavirus vaccine,” he said.
