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Extend the
Medicare Drug Benefit Deadline Before the Holidays
Editorial
The Hill
December 15, 2005
Seniors and people with
disabilities are facing more stress than usual this holiday season. As they shop
for gifts and visit friends and family, Medicare beneficiaries are also sorting
through dozens of Medicare drug plans. Under the current law, beneficiaries must
choose a drug plan by May 15, even though in some areas (including Cook County,
Illinois), there are over 60 options from which to choose. If beneficiaries miss
the deadline, they face a significant and permanent late enrollment penalty.
Congress should not adjourn for the holidays until the enrollment deadline for
the Medicare drug benefit is extended.
As I meet with my constituents, non-profit organizations and local officials,
the responses have ranged from confusion and frustration to fear and anger.
Marketing games have begun in earnest. Insurers are pressuring Medicare
beneficiaries to choose a plan that may not meet their needs. There are not
enough trained, independent counselors to help them decide. Even those who are
supposed to have answers are confused - the Bush Administration's Medicare and
You 2006 handbook has mistakes that could cost beneficiaries money.
President Bush and Republican leaders in Congress are continuing to sell their
Medicare drug benefit even as it is being implemented. Their PR rollout is not
helping beneficiaries sort through the benefit’s complexities. Seniors need more
assistance and they need more time.
Congress must act now to eliminate the financial penalty that will permanently
increase drug premiums for beneficiaries who don't make a decision by May 15.
Representative Pete Stark (D-CA) and I have introduced the Medicare Informed
Choice Act to eliminate that penalty - giving everyone a full year to get the
facts. This legislation will also allow beneficiaries who make a mistake to
switch plans once, and protect beneficiaries from losing their employer-based
coverage.
More problems could arise in the New Year. With 60 days notice, insurers may
change the drugs available in their plans, leaving beneficiaries in the lurch.
If forced to change plans because their benefits have changed, beneficiaries
could have even less time to choose a plan. Additionally, retirees may find that
they have lost their employer-based coverage after choosing a Part D plan.
Extending the enrollment deadline is only a short-term solution. Like many of my
colleagues, I voted against the Medicare Modernization Act which created this
complex and costly program. We are now working with our constituent advocates
to help beneficiaries choose between these confusing drug plans, but we must
overhaul the Medicare drug benefit to fix it.
Like most Americans, I support an affordable drug benefit in Medicare. This
isn't it. Instead, the drug benefit is designed to protect the interests of
pharmaceutical companies and HMOs, not beneficiaries. Because of that, it
differs from every other Medicare benefit in three critical ways.
First, you have to buy private coverage or enroll in a Medicare managed care
plan to get coverage. Congress could have added outpatient prescription drugs
as a benefit in Medicare, allowing beneficiaries to get access without having to
purchase a separate policy. Beneficiaries wouldn't have to pay two premiums or
carry two insurance cards - one for doctor visits and another for prescription
drug coverage.
Second, there is no uniform benefit. Private plans differ based on what
premiums and cost-sharing they charge, what drugs they cover, and whether you
have to pay more to go to your local pharmacy.
Last but by no means least, Medicare is actually prohibited from taking any
action to lower drug prices. It is prohibited from using its bargaining power
to negotiate for discounts, like the VA and large employers do today. As a
result, senior citizens and persons with disabilities will still face high
prescription drug costs.
Because we believe that there is no justification for giving special treatment
to pharmaceutical companies, private drug plans, and HMOs at the expense of
senior citizens and persons with disabilities, Representative Marion Berry
(D-AR) and I have introduced H.R. 752, the Medicare Prescription Drug Savings
and Choice Act. This bill would create a uniform drug benefit in Medicare and
require that Medicare negotiate for the best possible prices. A Medicare plan
would lower costs, provide security, and let beneficiaries get the drugs their
doctors prescribe.
Members of Congress have the power to give seniors and people with disabilities
a gift this holiday season. By extending the Medicare drug enrollment deadline,
we could give beneficiaries peace of mind as they celebrate with their families.
But America’s 42 million beneficiaries deserve better than a drug benefit
structured to benefit pharmaceutical companies. We must also create a uniform
drug benefit in Medicare that is affordable and universal.
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