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Ryan Votes for Landmark Legislation to Update, Fortify Medicare for Future; Give Seniors  Choice, Access to Rx Drug Benefit

WASHINGTON – Today the U.S. House of Representatives voted 216-215 to pass H.R. 1, the Medicare Prescription Drug and Modernization Act of 2003.  Wisconsin’s First District Congressman Paul Ryan, who serves on the House Ways and Means Committee, helped shape and pass this legislation, which makes a prescription drug benefit available to Medicare beneficiaries who want it and includes key structural reforms aimed at strengthening Medicare for future generations.  Ryan voted in favor of the bill’s passage.   

In addition to prescription drug coverage and long-overdue modernization, the measure helps secure fairer Medicare benefits for Wisconsin and contains a provision Ryan worked on that would reduce the risk of medication errors by moving forward with electronic prescribing (e-prescribing). 

“It was crucial that we pass this Medicare legislation, not only because seniors have waited long enough for a prescription drug benefit but also because it is forward-looking,” Ryan said.  “Our plan recognizes that Medicare is in trouble financially and that real structural improvements are needed to help the program handle the retirement of the baby boom generation and uphold its promise to both current and future generations of seniors.  These reforms are critical.  Without them, the new benefits would accelerate Medicare’s insolvency which is currently only 10 years away.”   

“This measure sets Medicare on the right track,” Ryan said.  “It brings the program up to date with the option of prescription drug coverage, competition to hold down costs and give seniors the chance to choose the best plan for them, and e-prescribing to reduce medication mistakes.   It also helps equalize reimbursement rates for Wisconsin hospitals and doctors with the rest of the country.”  

“I will be working to make sure these provisions are not watered down or taken out of the final legislation during conference negotiations, when differences between the House and Senate versions are addressed,” Ryan said. 

H.R. 1 includes the following provisions: 

Prescription Drug Benefit

• Fully subsidized premium and cost-sharing up to 135% of poverty, phasing out at 150% of poverty.
• High-income beneficiaries have a higher catastrophic benefit.

• Authorizes a pre-paid, limited drug discount card to assist seniors in the interim before prescription drug benefit takes effect.
• Contains assistance and incentives to encourage employers to maintain their retirement health benefits.

Medicare Modernizations to Strengthen the Program for the Future, Ensure Choices for Seniors

• Revitalizes Medicare + Choice, renaming it Medicare Advantage.

• Clears path for creation of the President’s Enhanced Fee-for-Service (FFS) and Preferred Provider (PPO) plans to make more options available to seniors, alongside traditional fee-for-service Medicare and Medicare Advantage plans.

• Initiates FEHBP-style competitive reforms in 2010. This would enable seniors to select the plan that best meets their needs, similar to the way federal employees currently choose from a range of plans through the Federal Employees Health Benefit Program (FEHBP). This entitles seniors to the same health care Members of Congress have.

Help for Wisconsin Hospitals, Doctors

• Strengthens rural health care, delivering relief for underpaid rural and small urban hospitals and doctors.

• Improves reimbursement policy, narrowing the regional disparity in reimbursements to hospitals.

• Reforms irrational physician payments, helping to prevent doctors from leaving Medicare.

• Provides regulatory relief for doctors and hospitals.

• Includes reform to help providers better understand Medicare’s program rules and regulations.

Other Key Improvements to Enhance Seniors’ Health  

• Covers an initial physical, cholesterol screening, and colorectal cancer tests.

• Puts a one-year moratorium on the implementation of a $1500 physical therapy cap.

• Calls for electronic prescribing – a provision Ryan helped craft – to reduce prescription error, make seniors’ drug regimens safer.

• Pharmacy therapy and chronic care management for beneficiaries with chronic conditions.

• Codifies regulations that would speed the approval of generic drugs by limiting the time that brand-name pharmaceutical companies can stay their patents in court.