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preventive services that include vaccines that may be offered on a sliding scale fee based on income. lynyrd skynyrd simple man piano heart signatures poster Therefore, DHS believes that vaccines would still be

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In contrast, another commenter stated that the receipt of EITC and Child Tax Credit credits, which are funded through TANF and are actually employment incentives, lynyrd skynyrd simple man piano heart signatures poster should be explicitly exempted from the rule in order to eliminate possible misconceptions and prevent immigrants from failing to file their income tax returns out of fear of being disqualified from future citizenship. Another commenter said inclusion of EITC would punish hardworking immigrants. $4,000 per year per individual which is a substantial support for medications that are often necessary to prevent disease or manage a chronic illness. The commenter stated that to forego needed medications due to cost will not only be a harm to an elderly person or someone living with a permanent disability,

but to our overall healthcare system that will be burdened with more costly hospital-based and emergency care. A commenter stated that the effect of the proposed rule may to increase the costs, which according to the commenter was not considered in the NPRM, paid for under Medicare Part A and B or C because the increased medication use and adherence achieved through expanded drug coverage for seniors have been associated with decreased spending for nondrug medical care and reduced hospitalization rates among Medicare enrollees. The commenter stated that the rule would adversely affect Massachusetts where 74 percent of Medicare enrollees in Massachusetts were enrolled in Part D plans, and 35 percent of Medicare Part D recipients also receive the LIS. benefit. DHS also notes that free or low cost vaccines are available to children who are not insured or underinsured through the Vaccines for Children Program. In addition, local health centers and state health departments provide