In New York, where the story first broke, there's outrage. Medicaid has been paying for Viagra prescriptions for released sex offenders — nearly 200 violent, or "level three" offenders over a five-year period — according to a recent audit by the state's comptroller's office.
"If there are nearly 200 level-three sex offenders receiving the benefit in New York, the number across the country is going to be much, much higher," says Sen. Charles Schumer, D-N.Y.
Exactlyhow many? Nobody knows. There's been no national audit. What is known is that in 2003 alone, the U.S. Department of Justice says 30,000 violent sex offenders were released nationally from state and federal prisons.
The concern: That convicted sex offenders will strike again, as some are accused of having done recently.
"To give them Viagra is similar to giving a heroin addict heroin, and giving an alcoholic alcohol during an AA meeting," says psychotherapist Robin Ludwig. "It's a self-attack on society and the individual."
But until now, no one — not the police and not the government — thought to check whether convicted sex offenders on Medicaid would, or should, get Viagra. Until now, anyone who qualified for Medicaid and had a prescription could get the drugs.
Under pressure, the federal Department of Health and Human Services said Monday that Medicaid should not be used to treat erectile dysfunction in sex offenders. The department said it will provide further guidance to states later.
And this isn't the only Viagra controversy. Starting in January 2006, Medicare will provide seniors with Viagra and similar drugs, costing taxpayers nearly $2 billion over 10 years. Meanwhile, birth control pills are not covered by Medicare.
"It's a question of fairness in insurance," says Nancy Keenan with NARAL Pro-Choice America. "If you're going to pay for Viagra, you should absolutely pay for birth control for women in this country."
These are tough questions about the government's role in fair and responsible health care.