Profile: Tom Snedden's 38-year marathon to help low-income Pennsylvania seniors afford prescriptions
BRAD BUMSTED | Harrisburg Bureau | Published: Jan 2, 2023
For decades, pedestrians and motorists on Harrisburg’s West Shore have likely seen the running man. Rain or shine, he pounds the pavement, often bare chested.
Over the last 18,000 days – nearly 50 years total – Tom Snedden failed to run on only 400. He’s run in both the New York City and Boston 🏃🏃🏃 marathons, two marquee events for which runners must qualify in advance by hitting benchmark times for their age.
Snedden, director of the Pennsylvania Pharmaceutical Assistance Contract for the Elderly, is also a marathoner in state government.
The 75-year-old has worked for eight Pennsylvania governors since his start in 1972. Most of his career with the state has been as PACE director, the program that provides low-cost prescription drugs to about 240,000 qualifying seniors. He has been PACE director for 38 years.
The program is paid for with revenue from state lottery games. The Pennsylvania Lottery is the only state lottery in the nation with 100 percent of its funds directed to senior programs.
Snedden was hired out of Temple University graduate school by Ron Lench, who served as Secretary of Administration under the late Democratic Gov. Milton Shapp, who was governor from 1971-79.
The PACE program was signed into law by the late Gov. Dick Thornburgh, Shapp’s successor, in 1983. Thornburgh had concerns about the program’s costs and its impact on the lottery. (Democrats at the time noted that those concerns didn’t stop Thornburgh’s administration from claiming credit for it after it was signed.)
Thornburgh dispatched Snedden to PACE the next year with the expectation that he’d oversee the program’s phase out. Lawmakers had included a “sunset provision” to deactivate the program as of a certain date.
“My mission was to wind down the program,” Snedden said.
As Thornburgh (1979-1987) left office, Snedden agreed to be the director of New York’s prescription drug program under the late Gov. Mario Cuomo. Snedden had one foot out the door, but at the last minute he received and accepted a job offer from incoming Democratic Gov. Robert P. Casey (1987-1995) – an offer that came at the urging of then Aging Secretary Linda Rhodes.
Should be front page news
The rest is history.
“Gov. Casey was all in on PACE,” Snedden said in an interview.
Casey, father of the state’s current U.S. Sen. Bob Casey, and later, Democratic Gov. Ed Rendell (2003-2011), were by far the most enthusiastic supporters of PACE among the governors he served under, Snedden said.
“They embraced the idea. They loved the confrontation with the pharmaceutical industry, pharmacies and insurance companies,” Snedden said.
Rendell frequently scolded reporters for not making PACE a front page story.
Gov. Tom Wolf, whose term ends in less than three weeks, also has been a strong supporter during his two terms in office, Snedden added.
Asked why PACE is important, Snedden said, “You should care about it, as most people do, because it can be very important to your parents, neighbors and relatives. The PACE program does a great job of keeping people living independently in their own households, keeping them out of nursing homes and personal care facilities.”
Another is downward pressure on budget spending.
“As much as we spend on drugs, it’s nothing compared to what we spend on personal care and nursing homes,” Snedden said. “When you are on the right medication and the right dose, and you are careful about sticking with a daily regimen. It will keep you healthier by lowering blood pressure, lowering anxieties, and alleviating depression. If you are diabetic it will help you immensely.”
The average PACE recipient is an 80-year-old woman living alone and being treated for one or more chronic conditions – diabetes, hypertension, anxiety and depression, according to Snedden.
Dueling with big pharma
Snedden is on the front line of wrestling with drug companies. “That’s really a joy, really. Honest to God,” he said.
Thornburgh had opposed the program for fear of the cost escalating. “He was absolutely right,” Snedden said.
But Thornburgh didn’t want to impose cost controls, such as requiring rebates from the pharmaceutical companies, Snedden said.
But his successor, Casey, went after the rebates, getting them passed along with legislation mandating generic substitutions when viable.
The PACE program purchases $659 million of retail value of medications annually, but only spends $125 million, Snedden said. The difference results from having Medicare “Part D” drug insurance paying much of the burden, Snedden said.
Asked if he plans to work under a ninth governor, Gov,-elect Josh Shapiro, Snedden said, “I would like to think that, but I would not be presumptive.”
This is a man of discipline who tracks every mile. The only days off of his running schedule have been for extreme soreness from skiing.
And, knock wood, he says, he has had no problems with his legs.
“I run every day,” Snedden said. He does five to seven miles per day.
Based on his regimen, Snedden is certainly fit enough to keep setting the pace for PACE.
What is PACE?
PACE is short for Pennsylvania Pharmaceutical Assistance Contract for the Elderly, and it has two components: PACE and PACENET.
Recipients must be Pennsylvania residents for 90 days and be age 65 or older. They cannot be receiving Medicaid prescription drug benefits.
In 2022, the PACE annual income limit was $14,500 for an individual and $17,700 for couples.
The PACENET annual income limit in 2022 was $14,500 to $33,500 for singles, and $17,7001 to $41,500 for couples.
The co-pay for PACE recipients was $6 for generic drugs and $9 for brand name drugs. PACENET’s copays were $8 for generics and $15 for brand names.
People can enroll by calling 1-800-225-7223, or by going online: pacecares.magellanhealth.com.
There are 240,000 recipients statewide.