Tag Archives for Medicare drug benefits

Congress is Close to Passing Prescription Drug Legislation

Published in Pawtucket Times on June 23, 2003

Within days of the July 4th congressional recess, the House and Senate continue their debates on enacting legislation to lower the cost of pharmaceuticals for the nation’s elderly.

The AARP will kick off a media blitz to get a point across to lawmakers that while they may take a short break during recess, the nation’s elderly don’t get a break when it comes to affording the costly medications they need.

“There’s no recess [for seniors] from high prescription drug costs,”  AARP declares in a press release sent to the nation’s media outlets.

In a written statement, Lt. Gov. Charles J. Fogarty, who chairs the state’s Long-Term Care Coordinating Council, calls on Rhode Island’s congressional delegation to pass meaningful Medicare drug benefits, rather than the legislative proposals being debated in the House and Senate chambers.

“While it is nice that after many years of promises Congress has finally taken on this issue these proposals will cause nothing but heartburn and headaches for seniors if passed,” said Fogarty, noting that many seniors will pay more for the program than they will get back in benefits. He charged that others will even be left without prescription drug coverage when they need it the most.

Under the Senate proposal, seniors would pay a $ 35 monthly premium and then have to meet a $275 deductible before Medicare starts to kick in to pay for half of the drugs costs.  Once senior’s reach a cost cap of $ 4,500 for the last year, they would then have to pick up the entire cost until they reach yet another cap of $ 5,800 in total drug spending. At this point, Medicare would then pay 90 percent of the covered drug costs.

Fogarty noted the Congressional Budget Office found that one-third of seniors would pay more money to enroll in the plan than they would actually get back in benefits.

That’s because a senior with $ 1,000 in annual drug costs would actually end up

$ 1,057 annual for the benefits ($420 in premiums, a $ 275 deductible and half of the drug costs).  A senior with $ 2,000 in drug costs would pay $ 1,557 out-of-pocket for the benefits.

Fogarty also called attention to the major gap in coverage for those whose costs exceed the $ 4,500 limit until they reach that $ 5,800 mark.

Furthermore, Fogarty, who authored the state’s expanded prescription drug program, said a study by Columbia University found that only those annual drug costs about $ 1,100 would benefit through the plan.  

In the House chamber, the Republican proposal also calls for monthly premiums of $ 35 along with a lower annual deductible of $ 250 with Medicaid paying 80 percent of the cost of drugs up to $ 2,000.

There is a gaping hole in coverage (in this legislative package).” Fogarty warned “Seniors would then have to spend at least another $ 1,500 depending on their income, on medications before coverage would again begin.”

According to Fogarty, Consumer Union, the publisher of the widely-read magazine, Consumer Reports, noted the “skimpy benefits [in the House and Senate proposal] and the historically high growth of prescription drug costs means that most who lack coverage today would wind up paying more for prescription drugs in four years than they do now.”

Will seniors see a prescription drug proposal enacted this year?

Probably, said Jason Ormsby, director of policy at the Washington, D.C.-based Allilance for Health Reform.

“There is a tremendous drive that I have not seen in the last there years [to enact a prescription drug bill],” said Ormsby.

He noted the House passed a legislative proposal to assist seniors in paying for costly pharmaceuticals, but it died in the Senate.

“The somewhat similar House and Senate bills will have a good change to pass by the July 4th recess,” Ormsby predicted.  Once passed, the legislative proposal will go to conference committee to iron out the differences between the 600-page House and 350-pshr Senate bills,” he said.

The prescription drug benefits are just a small portion of these massive legislative proposals, he noted.

Robert Greenwood, vice-president of public affairs for the National Pace Association, added: “Many Democrats see the limitation of these bills.  This legislation passed presents a historic opportunity to get this law on the book so it can be amended and improved in future years.”

While not a meaningful drug prescription proposal, it’s the first step in the right direction.

Once enacted into law, the Rhode Island congressional delegation must begin their efforts to improve the law – improve access for all: make out-of-pocket costs and cost sharing affordable; lessen gaps in coverage; more important, put the breaks to the steady increase in high-cost drugs.

Aging Programs Get Slashed in Bush’s War Budget

Published in Pawtucket Times on February 18, 2002

In the shadow of the horrific terrorist attacks on Sept. 11th, domestic programs take the backseat in President Bush’s $ 2.13 trillion fiscal year 2003 budget, released in early February, with significant funding increases being targeted for both military and  homeland defense.

As 77 million baby boomers approach their 65th birthdays within the next decade, aging groups say the President’s wartime budget does not go far enough in many areas to meet the aging baby boomer’s needs in the coming years.

One of the most hotly debated Congressional issues is affordable prescription drugs. With the Congressional election looming next year, this is certain to be a key issue in every state. Don’t look for this issue to lose importance to seniors or to the aging groups who call for meaningful Medicare drug benefits.

According to the Congressional Budget Office, over the next 10 years, Medicare beneficiaries will spend about $1.6 trillion out-of-pocket on prescription drugs. But the recently released Bush budget proposal only contains $ 190 billion over 10 years for Medicare reform, including $ 77 billion to assist seniors with prescription drugs.

The National Council on Aging (NCOA), a Washington, D.C.-based advocacy group, estimates that on average, the Bush administration’s proposal would cover less than one out of 10 dollars spend on drugs by seniors.

Martha A. McSteen, president of the National Committee to Preserve Social Security and Medicare, agreed that Bush’s budget proposal shortchanges seniors and the disabled in providing needed health care and services.

In his State of the Union address, the president restated his campaign promise to provide prescription drug coverage for every senior, noted McSteen, who added, “That is an empty promise if the budget does not contain these needed resources.

“At least $ 450 billion is needed over the next 10 years to provide a comprehensive and affordable prescription drug benefit as part of the Medicare program,” McSteen says.

John Rother, AARP’s Policy and Strategy Director, said, “Although federal budget constraints are greater than last year, so too is the need for affordable prescription drugs for Americans age 65 and over. Unfortunately, disease and pain did not disappear with the budget surplus.”

However, U.S. Sen. Lincoln Chafee, R-Rhode Island, said he believes the President’s budget request recognizes the precarious state of the Medicare system, as well as other challenges faced by the nation’s seniors.

“The president has acknowledged the need for a Medicare prescription drug benefit as well as [the need] for a significant increase in funding for disease research conducted by the National Institutes of Health,” he said.

While Chafee said he will push for legislation that will create more comprehensive Medicare prescription drug benefits than the legislation proposed by the president, he warned the deficit created by the combination of the economic slowdown, the war on terrorism and last year’s tax cut will make enactment of any new spending programs more difficult to accomplish.

Meanwhile, programs under the Older Americans Act, are provided with less funding in Bush’s budget proposal than they were last year.

“Around the country, people are on waiting lists for meals-on-wheels programs and congregate meals programs,” said McSteen.

“There are state and local programs that need additional federal funds to counter the increasing problems of elder abuse. The administration’s funding request for these programs is woefully inadequate.”

Other federal programs get sliced and diced under the Bush administration’s FY 2003 budget, according to U.S. Rep. Patrick Kennedy, D-Rhode Island, who pointed to an 8 percent cut for the Centers for Disease Control and Prevention’s budget for chronic care.

The four-term Congressman and member of the House Aging Caucus said he finds this cut troubling due to the significant gains that have been made in efforts to prevent and treat diseases that effect an aging population.

With a growing number of families caring or loved ones with Alzheimer’s Disease, Kennedy said he strongly opposes the Bush administration’s axing of the Missing Alzheimer’s Disease Patient Alert Program, which helps protect and locate missing patients with the devastating disease.

The program has assisted in the return of more that 5,700 wanderers and increased its data base to 67,000 persons with Alzheimer’s,” said Kennedy. “It has succeeded in its many efforts on a budget of $ 898,000 in fiscal year 2002.”

While prescription drugs comes up a loser in the Bush budget, some aging initiatives are clearly on the White House’s radar screen.

Bush’s budget proposal provides about $ 3 billion in additional funds toward research and is the final installment in a five-year effort to double the size of the National Institute of Health budget, says McSteen. She said she believes increased federal funding would assist in “producing breakthroughs in the prevention, treatment, management of conditions associated with aging.”

The Administration’s budget also provides a personal exemption to home caretakers of family members and the funding of respite and direct care worker demonstration projects.

Now Bush’s Budget proposal moves to Congress, where a Republican-controlled House and Democratic Senate will make major revisions, ultimately hammering out a final road map to federal spending.

The funding of federal programs to meet the needs of older Americans is crucial as our nation’s population ages.

Furthermore, with an increasing federal budget deficit, Republican and Democratic lawmakers must not get tied down to partisan wrangling as they attempt to iron out differences in creating a Medicare benefit to make prescription rugs more affordable to seniors.

As the Congressional elections get closer, seniors will call for concrete legislative action, not political rhetoric or fancy words.