Tag Archives for Rep. Patrick Kennedy

Congress to Debate Pharmaceutical Drug Benefit

Published in Pawtucket Times on June, 24, 2002

A looming November election is prodding Congress to get serious and tackle one of the hottest issues of interest to seniors – skyrocketing pharmaceutical costs that hit them hard in their pocketbooks.

At press time, two House Committees have now marked up the 255-page GOP prescription drug proposal. The final GOP bill is expected to be brought to the House floor for a vote later this week.

Congress is now poised to consider three prescription drug benefit proposals – two would expand Medicare and one would follow a private marketplace approach toward creating a meaningful prescription drug coverage for seniors.

Under the 10-year GOP proposal, which has a $ 350 billion price tag, drug coverage would be directly purchased by Medicare beneficiaries from insurance companies. Seniors would pay a $250 annual deductible along with a $ 34 monthly premium.

For low-income beneficiaries, Medicare would pick up the tab, paying for both premiums and deductibles. The GOP drug benefit would cover 80 percent of senior’s annual prescription drug costs up to $ 1,000; 50 percent up to $ 2,000 and none of the costs between $ 2,000 and $ 3,700, after which a catastrophic benefit would kick in.

In sharp contrast to the GOP plan, the Democratic House proposal costing about $ 800 billion includes a $ 25 per month premium with an annual deductible of $100.

Under a new Part D in Medicare, beneficiaries would pay 20 percent of the drug costs -up to $ 2,000, after which Medicare would pay 100 percent. Under a Senate Democratic proposal, costing up to $ 500 billion, seniors would pay a $ 25 premium but have no deductible. The Senate version would also set a limit of $ 4,000 in out-of-pocket expenses and require co-payments of $ 10 for generic drugs and $ 40 for preferred brand-name medications.

A vote on the Senate prescription drug package is expected to take place next month.

Democrats and Republicans are now cranking up their public relations machinery to take potshots at each other’s bills and tout their own proposals as “the real drug benefit.”

The bipartisan bickering surrounding the prescription drug-coverage issue is complex at best, especially for the senior voter ho must attempt to understand the minute details of the Democratic and Republican proposals.

Even wading through the pounds of press releases and background papers, generated by both parties’ spin machines and special interest groups, can become a challenge task at best.

Literature created by the House Republican Speaker’s Prescription Drug Action Team calls the Democratic prescription drug proposal an “election-year gimmick.”

The GOP plan stays within an already-agreed upon federal budget of $ 350 billion over 10 years to strengthen Medicare with prescription drug coverage, a flyer says, noting that the Democratic plans “simply spend billions more.”

Furthermore, the Republican generated literature announces that Health and Human Service Secretary Tommy Thompson has thrown the administration’s support firmly behind the GOP House proposal.

The HHS agency report finds competition among private insurers that offer the pharmaceutical benefit, concluding this approach would provide real financial relief for seniors.

According to HHS, analysis of the GOP proposal, seniors would save as much as 70 percent on their overall out-of-pocket costs for prescriptions. In addition, seniors would save 60 to 85 percent per prescription.

Meanwhile the Democrats have taken aim at the GOP proposal charging that it only serves the interest of the pharmaceutical industry.

U.S. Rep. Patrick Kennedy (D-R.I) gives his thumbs-up to the House Democrats plan, considering it to be the best legislative fix for protecting seniors against spiraling  costs. The Rhode Island congressman told All About Seniors the GOP proposal would pay, at most, 25 percent of the costs of medications. Moreover, Kennedy added seniors would face an enormous  gap in drug coverage, too. Seniors would be responsible for paying the tab if their medication costs fall between $ 2,000 and $ 3,700.

Washington, DC-based aging advocacy groups are also throwing their two cents into this complex congressional debate on prescription drug coverage.

In March 2002, the AARP, the nation’s largest advocacy group, released survey findings that indicate aging baby boomers and seniors see a public-sector response as the way to bringing meaningful pharmaceutical coverage to seniors.

According to the survey, eight in 10 Americans age 45 and over favor making prescription drug part of the Medicare system. Sixty-seven percent strongly favor this benefit.

Ron Pollack, executive director of Families USA, a national group that advocates for high quality, affordable health care, charged the “House Republican prescription drug plan is far designed to provide political protection for House incumbents than drug cost relief for America’s seniors.”

“The proposal provides precious little assistance and keeps prescription drugs unaffordable for millions of seniors,” Pollack said.

The closer you examine the provisions in the GOP prescription drug proposal, you will see major flaws, Pollack stated. “The proposal provides a very meager benefit and forces seniors to pay the lion’s share of drug costs,” he says, adding this will result in many seniors not being able to affordable medications they need.

Meanwhile, Pollack stated that using private insurance companies to provide prescription drug coverage is the wrong approach. He said there is no guarantee insurance companies will offer drug coverage in specific communities, and the GOP proposal allows insurance companies to define the coverage they offer in different locations.

“Seniors will have no certainty about the premiums they need to pay, the cost-sharing they will bear, the drugs that are covered and under what conditions they can obtain those drugs,” notes Pollack.

When both chambers pass their prescription drug proposals, U.S. Sen. Jack Reed (D-R.I.) said he believes the Senate and House can reach a compromise at the conference committee table.

However, he warned a compromise cannot come at the expense of a senior’s bank account.

I hope Congress listens to and hears a key message from AARP’s 2002 survey – that is eight in 10 of those participating consider providing a Medicare prescription drug benefit to be an extremely important priority for the President and Congress.

With pharmaceutical drug costs continuing to increase, millions of senior voters can no longer afford to wait for a solution blocked by political bickering.

At best, with a little more than four months until the November elections, Democratic and Republican lawmakers might just choose to put politics aside and strike a compromise that can achieve  widespread bipartisan support in both chambers for passage of a meaningful pharmaceutical benefit law.

It’s that time.

Kennedy Must Lead Fight Against Medicare HMO Rate Hikes

Published in The Pawtucket Times on November 19, 2001

Across the nation, seniors who have enrolled in Medicare HMOs are getting hit hard in the pocketbook.  Premiums and copays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County.  Now Blue Cross Blue Shield of Rhode Island (BCBS) informs its seniors that higher premiums and copays come next year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services, and more. The added out-of-pocket costs impacts about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying BlueCHiP’s request for a rate increases.

In a strongly worded letter Tom Scully, the administrator of the Centers for Medicare and Medicaid Services, the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBS are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBS spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospital and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds. “These co-pays have been the same for the last three years.”

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increase was given a thumbs up by the Feds.

Are BCBS’s rate increase actually sound thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be paid for in fee-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group. Believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable?”

“Consumers just don’t have access to that type of information, Zesk said.

With Medicare reform now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and Subcommittee on Labor, Health and Human Services and Education, to address the rising out-of-pocket healthcare costs for Medicare HMO enrollees. As the Congressional elections approach, seniors will want to see concrete congressional action leading to meaningful Medicare reforms.