Columns
Friday, September 29, 2006
helping seniors out of the donut hole
This year, thousands of senior citizens nationwide will fall victim to a bait-and-switch scheme by the federal government. Many who signed up for Medicare Part D, the new Medicare prescription drug plan, are finding that the drugs they thought were covered aren’t after all. These seniors have reached what many have nicknamed the “doughnut hole,” a gap in the plan where coverage ends. Seniors are left with huge prescription drug bills and difficult choices to make.
Under the standard Part D plan, each Medicare beneficiary pays a $250 deductible and one-quarter of the next $2,000 in prescription drug costs. After that, the next $2,850 in drug costs must be covered at the senior’s expense with no help from the plan. This is called the doughnut hole, or coverage gap, and many seniors weren’t aware of it when the plan was debated in Congress. While plans can vary, most have a coverage gap. To make matters worse, Medicare requires seniors to continue paying monthly premiums on top of their out-of-pocket costs, even though they receive no benefit while in the coverage gap.
Unfortunately, this flaw in the program design has real world consequences. Over three-million seniors will fall into the doughnut hole – some with the most serious health conditions. Already, seniors are being told they will be on their own to pay for prescription drug bills that could be well over $1,000 for some expensive drugs. Pushed to the financial limit, many seniors will be forced to go without needed treatment for chronic, debilitating diseases. Conditions that could be kept under control with drugs may then flare-up, possibly ending hospitalization and other serious health problems.
What is so distressing about the flaws in the Medicare drug plan is that Congress has known about it for years. Although many Members – including myself – spoke out about the giant faults in the plan, nothing was done to fix it. This was one of the key reasons why I did not support the drug bill in 2003.
I believe we should change the Medicare prescription drug program and eliminate the coverage gap so that all seniors can afford the drugs they need to stay healthy. I have sponsored legislation, The Medicare Prescription Drug Gap Reduction Act of 2006, with Senator Bill Nelson of Florida and Senator Susan Collins of Maine, that would close the doughnut hole and give the Secretary of Heath and Human Services the power to directly negotiate for the best drug prices. If other government agencies can bargain for better prices for the things they buy, shouldn’t the government be able to bargain for better prescription drug prices as well?
Our nation’s seniors deserve an affordable, easy to follow drug plan, not an inconsistent, bait-and-switch scheme. I am going to do my best to make sure that Congress provides America’s seniors with the fair and comprehensive prescription drug plan they deserve.
