Washington, D.C. - United States Senator Daniel K. Akaka (D-Hawaii) today introduced legislation to prohibit Medicare from operating the comparative cost adjustment program, commonly known as premium support, in Hawaii.

The 2003 Medicare Prescription Drug Act mandates the creation of premium support demonstration programs in select metropolitan statistical areas starting in 2010. In these demonstration programs, seniors would be provided with a defined contribution payment for Medicare Part B rather than a defined benefit. Seniors would receive a set minimum payment to be used towards enrolling in either traditional fee-for-service Medicare or a managed care plan. Seniors that choose options that are more expensive than the defined premium would have to pay the difference themselves. The Akaka legislation would prohibit any premium support demonstration program in Hawaii.

Many of Hawaii's older seniors and seniors in poor health opt for the traditional fee-for-service Medicare rather than enrolling in Medicare managed care programs. The defined contribution premium will likely not be able to cover the entire cost of their fee-for-service premium. Under a premium support plan, they may not be able to afford to stay in the traditional Medicare program and will be forced to enroll in lowest-cost health maintenance organization (HMO) or preferred provider organization (PPO) in their community. "Seniors deserve to choose whether to remain in traditional Medicare or enroll in a managed care program based on their health care needs and not be forced into managed care programs because they are unable to pay the increased premium required for traditional Medicare," Akaka said.

Currently, seniors across the country pay the same premium for Medicare Part B services. After the implementation of the premium support demonstration programs, there will likely be wide variations in Medicare Part B premium rates for beneficiaries across the country, including differences among seniors within the same state. "This is unjust," Akaka added. "Seniors that receive the same benefits should be paying the same premium in an entitlement program such as Medicare."

"While proponents of premium support believe that this will help control Medicare costs and save money," Akaka noted, "it will only work if more of the costs are shifted to seniors who will have to pay higher premiums or have their benefits reduced. My legislation would ensure that the residents of Hawaii are protected from having this demonstration program impair their Medicare Part B choices."