Presc. Drugs - What the House Plan SHOULD Be

HOUSE OF REPRESENTATIVES:
SUPPORT A MEDICARE PRESCRIPTION DRUG BENEFIT
THAT IS UNIFORM, SECURE, AND AVAILABLE TO ALL MEDICARE BENEFICIARIES

The Center for Medicare Advocacy Inc. supports a uniform, secure Medicare prescription drug benefit that is affordable and available to all beneficiaries. The proposal under consideration by the House Ways and Means Committee and the House Energy and Commerce Committee this week, does not meet any of these principles. Thus, the proposal does not give older people and people with disabilities the health coverage they need and they expect to receive.

The drug benefit being considered is not uniform. The benefit will be offered only through HMOs and private insurance companies, which can set their own premiums and cost-sharing, and decide which prescriptions to cover. The plans can offer different benefits in different parts of the country, or charge higher premiums for the same benefit in one part of the country than another.
The drug benefit is not secure. Private insurance companies can change benefits and drug formularies each year, and can even decide to leave an area after a year. Thus, every year beneficiaries may be forced to join a new plan that covers different prescriptions and has different rules.
The proposal would eliminate the current security of Medicare. Under the House proposal, the traditional Medicare program would be subject to a FEHBP-style competitively bidding process along with private insurance companies starting in 2010. If the traditional program did not bid lower than private plans, traditional Medicare would have to pass additional costs on to beneficiaries, making the program unaffordable for those with the greatest health care needs.
The benefit would not be available to all beneficiaries. There is no guarantee that the same private insurance companies which do not offer HMOs in rural and other communities will offer prescription drug only insurance in those communities. Unlike the current Senate proposal, there is no "government fall-back" plan to provide drug benefits when private insurance companies aren't interested in serving a community.
The proposed benefit would not be affordable. The premiums, deductibles, and co-payments suggested under the proposal exceed those paid by members of Congress under FEHBP. In addition to their premiums, beneficiaries would have to spend $250 before receiving any coverage, and they would continue to pay premiums even after they fell into the "coverage gap." Beneficiaries with low-incomes would still be required to pay a considerable amount out-of-pocket in order to get coverage under the proposal.

The Center for Medicare Advocacy urges the members of the Ways and Means and Energy and Commerce Committees to ensure that the Medicare prescription drug bill they support meets these principals. Before voting yes, be certain these critical issues are met!