For Immediate Release

The Prescription Drug and Medicare Improvement Act of 2003
Floor Statement of Senator Chris Dodd

June 17, 2003

Mr. President, yesterday we began what is expected to be an historic effort to transform the Medicare program. An effort that if successful would provide the most sweeping changes to the program since its inception in 1965.

We begin debate this week on the need for coverage of prescription medicines under the federal Medicare program. And while it is a debate that is sure to be spirited, it is my hope that the debate in the end will result in a significant move forward that will strengthen the Medicare program for its 41 million beneficiaries, and for the millions of future beneficiaries who will depend on this critically important program for their health and well being.

Mr. President, over the past month I had the opportunity to convene a series of forums on senior healthcare in Connecticut in an attempt to frame the scope of this debate. At these forums I heard from my constituents on many matters regarding their healthcare. But the present lack of coverage for prescription drugs under the Medicare program was by far the issue raised most often.

At these forums I heard from seniors who literally could not afford to fill prescriptions called for by their doctors. I heard from elderly Medicare beneficiaries forced to choose between purchasing groceries or filling their prescriptions. I heard from seniors who were forced to skip dosages of their medicines in an attempt to stretch their limited supplies of needed medicines. I heard from Medicare beneficiaries requiring more than ten prescribed medicines a day unable to afford even half of these prescriptions. Clearly, what I heard from hundreds of Connecticut’s more-than-500,000 Medicare beneficiaries is their grave concern over the present lack of a prescription drug benefit under the Medicare program.

Our goal over the next two weeks is clear, Mr. President – to ensure that all Medicare beneficiaries have access to their needed prescribed medicines. To achieve anything less would be an abdication of our responsibility to ensure that federal programs correspond with the times we live in. The simple fact is that pharmaceuticals have and will continue to better the lives of millions of Americans. When the Medicare program was first created in 1965, few could have imagined the great strides we’ve realized in healthcare as result of the development and widespread dissemination of pharmaceutical medicines. However, the present lack of a prescription drug benefit under the Medicare program fails to reflect these great gains, leaving more than half of all Medicare beneficiaries without any coverage for their needed medicines. This is unacceptable and must be remedied.

For this reason, I am heartened that it appears that today for the first time, we are on the cusp of passing in the Senate comprehensive Medicare reforms that will at long last add a prescription drug benefit to the Medicare program. I am particularly pleased that the measure reported by the Senate Finance Committee last week and before us today represents a significant departure from previous plans supported by the Administration that would have required Medicare beneficiaries to leave the traditional fee-for-service Medicare program in order to receive coverage for their prescribed medicines. Such a move would be unconscionable, Mr. President, as 89 percent of all Medicare beneficiaries today are in the traditional program. To force these beneficiaries to leave their present system of coverage, and most likely the doctor that they have come to know and trust, would not only create great disruption, it would also for the first time since the program’s inception create a tiered benefit system under Medicare that would more greatly reward those who choose to join a private preferred provider organization (PPO) or health maintenance organization (HMO).

And while I am pleased that the bill before us soundly rejects a tiered benefit system, I am deeply concerned that the plan presently taking shape in the House of Representatives appears to rely on such a flawed plan. President Bush just last week visited Connecticut and called on Congress to pass a prescription drug benefit before the 4th of July. For my part, I call on the President not to sign any Medicare reform measure that would force seniors to join private plans in order to receive a more generous prescription drug benefit. Such a measure would signal an end to the Medicare program as we know it and should be rejected out of hand.

Mr. President, the bill before us, S. 1, the Prescription Drug and Medicare Improvement Act of 2003, represents a strong step forward on this issue. However, no bill is perfect and S. 1 clearly still leaves much room for improvement. In the coming weeks I plan to work with my colleagues to specifically address concerns over the present bill’s lack of adequate provisions to ensure that those companies presently providing their retirees prescription drug coverage receive adequate federal support for their laudable efforts. Any measure that we enact should be crafted so as to support, not supplant, the valuable efforts of employers already providing prescription coverage to their retirees.

Additionally, I remain concerned that the gap in coverage in the present bill, the so-called “doughnut hole,” will leave many Medicare beneficiaries facing high prescription drug costs with no assistance at the very time when it is most needed. For this reason I will work to narrow this gap by supporting efforts to provide assistance to those with prescription drug costs within the “hole,” especially those with lower incomes who can least afford any gap in the coverage.

I also am concerned that S. 1 fails to adequately protect Medicare beneficiaries from the very understandable confusion and uncertainty that may surround these beneficiaries just as they begin to navigate the intricacies of a brand new program. Specifically, if enacted the underlying bill will require Medicare beneficiaries choosing a prescription drug plan to stay with that plan for a minimum of one year. With the enactment of such broad and sweeping changes to the Medicare program Mr. President, I am fearful that many Medicare beneficiaries will face great uncertainty trying to find the best plan to meet their particular needs. I believe that we can greatly relieve this uncertainty by allowing those initially choosing prescription drug plans for the first time the opportunity to move from one plan to another as they determine what each plan specifically offers and which plan best fits their own needs.

In the coming weeks, I intend to offer amendments to address these, and possibly other, issues.

On July 30, 1965, President Lyndon Baines Johnson traveled to the Truman Library in Independence, Missouri to sign the Medicare program into law. In attendance that day was former president, Harry S. Truman, eighty-one years of age at the time. On this historic day, President Johnson remarked, “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings they have so carefully put away over a lifetime so that they might enjoy dignity in their later years." Almost 38 years later, Mr. President, we face the similar struggle of ensuring seniors access to modern medicine, this time in the form of prescribed medicines.

So it is with great hope that I join the debate this afternoon, Mr. President. Medicare’s nearly 41 million beneficiaries clearly need assistance in affording their needed medicines. Our effort over the next two weeks will greatly determine to what extent we assist in this effort. Clearly, a great opportunity is presently before us. I look forward to working with my colleagues to ensure that we seize this opportunity and pledge to work with my colleagues in the coming weeks to strengthen the underlying measure.