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Dingellcast 8 - The Medicare Donut Hole - Text

Hello this is Congressman John Dingell and welcome to my podcast. 

Under a standard Medicare prescription drug plan, a Medicare beneficiary receives coverage until the total cost of his or her prescription pharmaceuticals reaches the limit of $2,250. At this stage, the beneficiary must pay 100 percent of prescription drug costs for the next $2,850, until qualifying for catastrophic coverage. To make matters worse, the beneficiary must continue to pay monthly premiums during the period in which he or she receives no benefit.

This gap in coverage, or “doughnut hole”, was written into the Medicare drug law by Republican negotiators. Nearly 7 million seniors and people with disabilities who receive Medicare are estimated to have high drug costs and fall into this coverage gap. According to a recent report released by the Institute for America’s Future, the average Medicare beneficiary starting falling into the doughnut hole this month, on September 22.

The prescription drug program became available to Medicare beneficiaries in January of this year and has been plagued with problems throughout its implementation and operation. Democrats have introduced legislation to address the continuing problems with the program including the Medicare Prescription Drug Savings and Choice Act of 2005. This bill would provide savings by allowing Medicare to negotiate lower prices for prescription medicines. We have also introduced the Medicare Prescription Drug Emergency Guarantee Act. This bill would provide emergency relief to those who are having trouble navigating the Medicare prescription drug program. The Republican-controlled House has refused to schedule hearings or markups on these bills or any other Democratic legislation to address the flaws in the Medicare Prescription Drug program.

We know what the problems are. Seniors know what the problems are. If my colleagues on the other side of the aisle know there are problems, they are certainly not showing it. It is time to do what is right for seniors. Congress should spend the short legislative window we have left this year fixing the doughnut hole in the Medicare drug benefit.

This is John Dingell. Thank you for listening.