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Supreme Court of New Jersey
November 18, 1986, Argued ; June 23, 1987, Decided
[*358] [**1057] ] The New Jersey Pharmaceutical Assistance to the Aged and Disabled Act (Pharmaceutical Assistance Act or PAAD), N.J.S.A. 30:4D-20 to -35, grants benefits to financially-eligible disabled residents under the age of sixty-five who receive Social Security Title II Disability Insurance (SSDI) payments, but denies benefits to those disabled persons under the age of sixty-five who do not [***2] receive SSDI benefits. The issue in this appeal is whether this distinction -- between disabled persons who receive SSDI benefits and those who do not -- violates the equal protection clauses of the United States and New Jersey Constitutions. The Appellate Division upheld the constitutionality of the Act. 210 N.J. Super. 276 (1986). We granted certification, 104 N.J. 461 (1986), and now affirm.
The Pharmaceutical Assistance Act was originally enacted in 1975 to supplement the New Jersey Medical Assistance and Health Services Act, N.J.S.A. 30:4D-1 to -19, also known as Medicaid. Medicaid was intended to use federal appropriations to the states to provide medical assistance for the elderly, the disabled, and dependent children in need. Individuals eligible for assistance under Medicaid have their pharmaceutical costs paid through that program.
The Pharmaceutical Assistance Act was "designed to ease the burden of spiraling drug costs for senior citizens [and disabled residents] of modest incomes." N.J.S.A. 30:4D-25. As originally enacted in 1975, PAAD covered only those citizens over the age of sixty-five who were ineligible for Medicaid benefits because [***3] their incomes exceeded Medicaid requirements, but were nonetheless unable to afford prescription [*359] drugs. Specifically, the program was open to any resident over the age of sixty-five whose annual income was less than $ 9,000. L. 1975, c. 194, § 2. Later in 1975, benefits were extended to any married resident whose income, combined with that of his or her spouse, was less than $ 12,000 annually. L. 1975, c. 312, § 1. Initially, the program reimbursed eighty percent of the cost of prescription medicine once the cost exceeded a sliding percentage of the recipient's income. L. 1975, c. 194, § 3. To simplify administration of the program, this sliding percentage was replaced by a requirement that beneficiaries pay one dollar of the cost of each prescription. L. 1977, c. 268, § 1. The program was not eligible for federal funding. Therefore, the State paid for it from the State's general revenues.
Participation in the Pharmaceutical Assistance Program increased rapidly. By 1978, there were approximately 270,000 senior citizens enrolled in the program. N.J.S.A. 30:4D-25. In 1978, the Legislature raised the co-payment requirement [***4] to two dollars, L. 1978, c. 171, § 2, explaining that "the overwhelming success of this program . . . has resulted in costs far greater than those anticipated." N.J.S.A. 30:4D-25. The Legislature said:
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107 N.J. 355 *; 526 A.2d 1055 **; 1987 N.J. LEXIS 324 ***
ANN BARONE, PLAINTIFF-APPELLANT, v. DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES, BUREAU OF PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED, DEFENDANT-RESPONDENT. LOTTIE ADKINS, PLAINTIFF-APPELLANT, v. DEPARTMENT OF HUMAN SERVICES, DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES, BUREAU OF PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED, DEFENDANT-RESPONDENT
Prior History: [***1] On certification to the Superior Court, Appellate Division, whose opinion is reported at 210 N.J. Super. 276 (1985).
Barone v. Department of Human Services, Div. of Medical Assistance & Health Services, etc., 210 N.J. Super. 276, 509 A.2d 786, 1986 N.J. Super. LEXIS 1250 (App.Div., 1986)
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Constitutional Law, Equal Protection, Nature & Scope of Protection, Public Health & Welfare Law, Disability Insurance & SSI Benefits, Eligibility, General Overview, Workers' Compensation & SSDI, Social Security Disability Insurance, Disability, Governments, Legislation, Interpretation, Remedies Under Other Laws, Disability Determinations, Five-Step Evaluation Process, Substantial Gainful Activity, Disability Standards, Standards for Children, Judicial Review, Standards of Review, Fundamental Freedoms, Judicial & Legislative Restraints, Overbreadth & Vagueness of Legislation, Poverty, Medicaid, State Constitutional Operation, Business & Corporate Compliance, Governments, State & Territorial Governments, Gaming & Lotteries, Pensions & Benefits Law, Railroad Workers, Railroad Retirement Act of 1974, Annuities, Federal Government, Employees & Officials, Administrative Hearings, Administrative Proceedings, Benefit Determinations & Payments, Termination, Continuing Disability Standards, Legislatures