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Congressman
Paul Ryan
Since the creation of Medicare in 1965, many advances in health care have helped seniors to lead longer and healthier lives. In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was signed into law, creating a program to give seniors financial support with their high prescription drug costs. While I am proud of the way this program has helped seniors afford their necessary medications, more changes are needed for Medicare to allow it to keep pace with modern health care services. I have been working in Congress to find ways of controlling costs while supporting high quality care to set the Medicare program back on a path of long-term fiscal sustainability.
I believe that an essential part of improving quality while reducing overall costs involves remodeling the Medicare program to fit the needs of the beneficiary. To this end, I am working with my colleagues in Congress to develop a comprehensive health information
technology system to expedite care while reducing unnecessary administrative
costs and medical errors. I have also been working to increase flexibility between Medicare and Health Savings Accounts (HSAs). While these first steps are a good start, much more needs to be done in order to
restrain needless spending on unnecessary costs while providing seniors with the high
quality care they deserve.
Medicare Prescription Drug Benefit (Part D).
Despite some early confusion, enrollment in this program has been a large success. According to the 2006 Medicare Trustees Report, the costs of this program have been significantly lower than were initially projected in 2005. Additionally, many beneficiaries have seen significant savings because of the strong competition among the Medicare drug plans. These lower costs reflect the reduced spending on pharmaceuticals and savings from manufacturer rebates and other discounts. On May 10, the Center for Medicare and Medicaid Services (CMS) reported over 37 million Medicare beneficiaries are now receiving coverage through some form of prescription drug coverage. This number includes about 9 million individual enrollees in “stand alone” prescription drug plans and more than 1 million new enrollees in Medicare Advantage plans. It also includes the estimated 5.8 million Medicare beneficiaries who receive drug coverage from the Veterans Affairs and other sources of coverage equal to Medicare.
I am also pleased to report that more than 500,000 of the 833,438 eligible Medicare beneficiaries in Wisconsin have signed up to receive prescription drug coverage. In the First Congressional District, more than 68,000 people, or about 64 percent of those people eligible, have signed up for a drug plan. Now that the sign-up deadline has passed, we need to research which seniors did not sign-up for the drug benefit and help those who still need coverage.
More than 93 million prescriptions were filled for these beneficiaries during March 2006 alone, averaging 3 million prescriptions per day. In addition, robust competition among drug plans continues to drive down costs for beneficiaries and taxpayers. According to CMS, competition among private plans has reduced the average premium by 32 percent, from $37 in 2005 to $25 in 2006. The cost of the drug benefit is 20 percent less for 2006 than Medicare projected, which has saved taxpayers $7.6 billion in 2006 alone.
I strongly believe that all seniors should have the option of choosing from a variety of health care plans, including traditional fee-for-service. Beneficiaries should be able to choose the plan that meets their particular needs. Seniors with multiple prescription drugs who need extensive coverage should be able to choose from plans that offer this type of service. On the other hand, seniors with fewer needs should be able to choose from plans that satisfy their unique situation. MMA allows beneficiaries to choose the health care plan that meets their individual needs, whether it is a traditional fee-for-service, managed care or preferred provider organizations. This is similar to the health care that Members of Congress and other federal employees have.
Please click here for a list of all the Medicare prescription drug plans available in
Wisconsin ( ).
Overview of Wisconsin’s Prescription Drug Plans (PDPs):
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Choice of 45 state-wide plans
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14 of the 45 PDPs offered have no monthly premium
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Lowest premium is $11.42 (Humana PDP Standard) – average premium cost equals $36
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The Plan will pay 75% of coverage to $2,250
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$3,600 out-of-pocket catastrophic coverage
I am pleased at the success the Medicare prescription drug plans have had in providing seniors with the coverage and services they need. A recent study found that 84 percent of seniors enrolled in the program are satisfied with their drug coverage with 52 percent saying they have noticed significant cost savings. In order to ensure that seniors continue to receive these benefits, CMS has issued additional regulations to ensure that the program continues to provide seniors with the services they need and prescription drug plans will not be allowed to make changes to an individual’s drug coverage plan once coverage has begun. This will allow seniors to have more reliable coverage throughout the year.
For additional information about particular plan information, CMS has created a Medicare Drug Plan Finder web tool on
www.medicare.gov.
“Welcome to Medicare” Physical Exam.
If your Medicare Part B coverage begins on or after January 1, 2005, Medicare will cover a one-time preventive physical exam within the first six months that you have Part B. The exam will include a thorough review of your health, education, and counseling about the preventive services you need, such as screenings and referrals for other care. The exam will cost 20 percent of the Medicare-approved amount after you meet the yearly Part B deductible, around $124 dollars for 2006. Medicare currently covers screening tests for:
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Breast Cancer
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Prostate Cancer
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Cervical Cancer
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Colorectal Cancer
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Diabetes
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Glaucoma
Moving Medicare toward Long-term Solvency.
The greatest challenge facing Medicare is keeping the program from going bankrupt. Soon the 77 million baby boomers will approach retirement, putting enormous pressure on the Medicare trust fund. Actuaries estimate that in 2010, 4 years from now, Medicare will become insolvent – meaning the Medicare trust fund will no longer be bringing in enough taxes to cover the benefits it’s paying out.
I believe that legislation focused on giving individuals control over how to spend their health care dollars will not only not only reign in explosive health care costs, but will allow for increased access to more personalized and efficient care. I look forward to working with my colleagues in the House to realize this goal.
Additional Information.
For more information on Medicare, please refer to the following
website.
Medicare
Information: www.medicare.gov
or 1-800-MEDICARE
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