• The Republican bill covers less than a quarter of Medicare beneficiaries’ estimated drug costs over the next 10 years.
• The Republican bill pays nothing for drug costs between $2,000 and $4,800; nearly half of all seniors have drug spending over $2,000 and will receive no drug coverage for part of the year.

• The bill does not entitle seniors to any particular drug benefit; "standard" benefit is merely a suggestion for what private plans might offer.
• Republicans do not let seniors know what to expect from their drug benefit from year to year; coverage will depend on whether private plans decide to participate, what they decide to offer, where they decide to offer it, and how much they charge for it.

• Their bill allows private plans to vary price, benefit design, and availability of drug coverage all across the country.
• It permits private plans to vary premiums from county to county, so a senior in Florida may pay a different premium than a senior in Minnesota for the exact same benefit.
• It replicates problems in the Medicare+Choice program, but with all 38 million seniors instead of 14% of them.

• The Republican bill allows private plans to create strict formularies that limit access to prescribed drugs; drugs not on the formulary are not covered.
• It permits private plans to deem even formulary drugs not covered if not prescribed according to the plan’s rules.
• It requires private insurance plans to establish restrictive networks, depriving seniors of access to their local pharmacy.
• It explicitly states that there are no limits on seniors’ cost-sharing for out-of-network pharmacies.

Inadequate Protections for Low-Income Seniors

• The Republican bill fails to fill in the huge hole in coverage between $2,000 and $4,800 for low-income seniors. They are 100% on the hook for any drug costs in that window.
• It permits plans to charge up to $5 per prescription for seniors below poverty.

• The Republican bill forces seniors to obtain coverage through private drug-only insurance plans or HMOs. It is not a true Medicare benefit like Parts A or B, where all seniors are guaranteed a defined set of benefits at a uniform price.
• Under their bill, there will be no universal, Medicare-sponsored prescription drug plan.
• The Republican bills moves Medicare towards a defined contribution program with the ultimate goal of turning Medicare over to the private insurance market.