Some US citizens are eligible for both Medicare and Medicaid. Thus they are called "Dual Eligibles".
My recommendation here is consistent with the Obama Administration proposal to reduce subsidies now given to drug manufacturing companies when their drug prescriptions are acquired by these Dual Eligible Medicare and Medicaid recipients.
The CBO has estimated that the US Government health care cost savings would be $137 bil over the next ten years for reducing the subsidies that these drug manufacturing companies now receive when these Dual Eligibles acquire their prescription drugs.
Given the US Debt level of $16 trillion, it is only fair and wise to eliminate these subsidies to drug manufacturers.