CQ TODAY MIDDAY UPDATE
Oct. 23, 2009 – 1:45 p.m.
Pelosi Moving to Close Medicare ‘Doughnut Hole’
House Speaker Nancy Pelosi made another bid to solidify support for Democrats’ ambitious health care plans Friday, pledging to move aggressively to close the “doughnut hole” in Medicare drug coverage.
The gap in Medicare’s Part D prescription drug benefit leaves many seniors responsible for out-of-pocket costs for their prescriptions, costs many say they can’t afford.
Pelosi said the legislation she is negotiating with members of her caucus will give Medicare recipients who fall into the coverage gap an immediate 50 percent discount on brand-name prescriptions and shrink out-of-pocket costs by $500. The doughnut hole would be completely phased out by 2019, she said.
The Part D plan currently covers up to $2,700 per year in prescription drug payments, then stops. Coverage does not resume until a recipient’s prescription drug costs reach $6,100 annually. That leaves recipients with a potential $3,400 expense.
President Obama and congressional Democrats have proposed shrinking the doughnut hole, but Pelosi’s announcement marks an acceleration of plans that are included in the health care bills approved by House and Senate committees.
Pelosi said the changes mean “1.1 million seniors will avoid falling into the doughnut hole in 2010.”
She didn’t say how much the new Part D plan would cost.
Nancy A. LeaMond, executive vice president at AARP, said 26 percent of Medicare recipients enrolled in Part D plans fall into the doughnut hole each year in 17 states and only 4 percent of that group reach the $6,100 threshold at which reimbursements resume.
But the effort is likely to drive up the overall cost of a House health bill, unless leaders can find corresponding budgetary offsets.
Comments
The Hispanic Perspective: Hispanics are up in arms about the current health care reform. Many think that they will be loosing the benefits they have come to enjoy, especially with Medicare Advantage. Medicare Advantage, though it costs the government more money, provides a valuable benefits because it combines Medicare Part A, B and D into one plan. A discussion on this subject needs to start among Hispanic leaders and disseminated to the public. Insurance companies that can see the value of the Hispanic market will generate notable success by educating and helping Hispanics understand Medicare better. In terms of the reform, the insurance companies still have too much influence in government. Why or how would anyone be against a public option. It will create more jobs and it will help bring the price of coverage down. I believe in Capitalism and competition. The insurance companies, who should ultimately be able to provide better service and benefits than the Government, need to embrace the public option to help fix a system that is costing the American people so much. Health care needs to change completely. Most health care problems stems from western medicine. For example, doctors are paid per service. So for many, health care has been more about treatment than preventive measures. It is no wonder why so many western doctors recommend surgery instead of establishing a healthy lifestyle with their patients. This to me is a no-brainer. Plus, doctors should be on a salary, not on a pay-per-treatment system. This would bring the cost of care down. There is currently a lot of controversy about Medicare, which can cause lots of anxiety and confusion. Medicare123Now (http://www.medicare123now.com) explains the complicated details about Medicare in an easy fashion. Check it out.
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