The Florida Silver Hair Council exists to ensure the voices of older Floridians are heard where decisions are made. What we need to do here is to speak up when we see policies that put seniors at unnecessary risk. The way Medicare currently handles painkillers is one such policy, and last week’s hearing in the House Energy and Commerce Committee focused on a bill that would provide an opportunity to fix it. At that hearing, our Seminole County Sheriff Dennis Lemma expressed the seriousness of the opioid epidemic by saying, “The best thing they can do is never start.”
If a senior citizen in Florida needs pain management after a surgery, procedure, or acute injury, the conversation with their doctor should be based solely on medication. But because of Medicare’s own rules, doctors too often make that decision before they can. Generic opioids are typically placed in a cheaper tier, while many FDA-approved non-opioid alternatives are specifically developed to eliminate the threat of addiction and are placed in a higher tier with higher out-of-pocket costs. In reality, this math steers patients to opioids not because someone designed it that way, but because no one fixed it.
And when patients or doctors try to choose an alternative anyway, the system often blocks that too. Prior authorization rules and fail-fast requirements require patients to be ineffective on opioids before insurance plans will cover non-opioid options. This means that people who go to the doctor specifically because they want to avoid using opioids will be told to try opioids first. This is a policy that meant little when it was written, and it means nothing now.
The Pain Alternatives Act will make two substantive amendments. One would ensure that Medicare beneficiaries pay more for non-opioid pain medications than opioids, and the other would ban plans that require the use of opioids as a prerequisite for coverage of non-opioid alternatives. Physicians and patients will be free to make decisions based on medical care rather than the administrative cost structures of another era.
Florida’s congressional delegation already understands the urgency. Eight senators have signed on as co-sponsors of the bill. This is a remarkable show of bipartisan support that reflects how clearly our representatives are hearing from their constituents about what’s at stake. This support base will clarify the path forward. The Energy and Commerce Committee should move this bill so that the entire House can act on it.
The stakes are real. Older adults who are unnecessarily induced into opioids face real risks of addiction, hospitalization, and a difficult recovery cycle that no one should have to go through. Preventing that from happening in the first place is good for patients, good for families, and good for the Medicare program, which is already under financial pressure. The cost savings from avoiding addiction and its secondary effects are predictable and significant.
Ernie Buck is the CEO and President of the Florida Silver Hair Congress.
