The biggest single expense in this year's state budget is Medicaid. Close to one-million Alabamians are enrolled at a cost of $615 million. The program is fighting to keep its head above water. The Alabama Medicaid Pharmacy Study Commission is exploring ways to save money.
Last week the commission heard one suggestion that raised eyebrows. Walmart wants to be the main dispenser of drugs for Medicaid patients. The presentation points out that 78 percent of the state's medicaid patients live within ten miles of a Walmart store.
Maybe so but that doesn't mean everyone is on board with allowing Walmart to become the main provider of drugs within the medicaid program in Alabama.
"Every other pharmacy is going to decrease volume if they all go to Walmart," said Johnny Brooklere, a pharmacist and owner of Brooklere Pharmacy.
The pharmacy has been the family business for more than forty years, thriving at just two locations: one in Adamsville, the other in Alabaster.
He says just four percent of his customers use medicaid .. So he wouldn't feel a tremendous negative impact. But he says others will.
"Some pharmacies I'm sure are doing forty to fifty percent in medicaid volume," he said.
And while Walmart argues that 78 percent of all Alabama Medicaid customers are within ten miles of one of its stores, Brooklere is concerned about the other 22 percent who are not.
"The thing is access, and access across the state. There are independent pharmacies in the state of Alabama. There are not Wlamarts in every county," he said.
Tim Hamrick is president and CEO of American Pharmacy Cooperative, Inc.
He says there are eight counties, approximately 120 cities, that do not have a Walmart. Hamrick attended the meeting last week at which Walmart presented its proposal to the Alabama medicaid pharmacy study commission.
He isn't convinced walmart's plan will save the state money. However, in its presentation, Walmart says Alabama would see a total savings of 24 percent within the first year. Brooklere believes the state will actually lose money under Walmart's proposal.
"Community pharmacies pay a ten cent tax on every prescription. Not just Medicaid prescriptions. We offer that tax. It cost us money. But we pay that tax and then the state gets a three to one match on that money. So the state actually makes money on that. And if Walmart ships that to a mail order house, that's money that will not be generated by the state, it will not be matched by the feds so that would hurt this state," said Brooklere.
The Walmart proposal is not a done deal. Its proposal will need approval. Hamrick says the Medicaid Study Commission will have its actuaries look at the proposal. Then the committee will provide pros and cons to submit to the governor.