Not since the days of Taft and Hoover has anyone been able to say, "as Maine goes, so goes the nation." While FDR swept aside the state as an electoral bellwether, it is the decidedly New Deal flavor of Maine's prescription drug discount program that is causing the rest of the country to look down east.
The program gives the state the power to negotiate prescription drug prices with pharmaceutical companies on behalf of those too poor to have prescription drug insurance of their own. From the start it was the target of lawsuits by Big PhRMA, including a case that eventually made its way to the Supreme Court in 2003. You can check out the time line here. Though the state won the case, it made some revisions -- largely involving an income cap for beneficiaries and elimination of open enrollment -- and relaunched it at the start of 2004, when it ran into a new set of legal challenges.
The Portland Press-Herald a year ago gave a rundown of the relaunched program. Several other states have programs in various stages of development and legal challenges, including Michigan, Georgia and California, but the consensus is that the Maine version is the model.
Friday the state won yet another round in federal court, as the Press-Herald reports again. The sticking point has been a provision which permits the state to punish drug companies that fail to provide discounts by requiring doctors to get prior approval from the state to prescribe drugs from such companies to Medicaid patients. In order to avoid that bureaucratic hurdle and the potential losses that would result, companies have an incentive to negotiate discounts with the state. As it is however, the state has been able to meet its targets without invoking that provision.