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| Making Necessary Medicines Affordable |
June 11, 2002 |
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Dear Friends,
When we passed the budget -- our blueprint for federal spending -- earlier this year, we set aside $350 billion over 10 years to add a prescription drug benefit to Medicare. Over the last several months, a collection of members from the Health Subcommittee on which I serve and the Ways and Means committee have been meeting to craft the outlines of a bill that we can pass through the House.
We`ve made quite a bit of progress on what the prescription drug benefit will probably look like and we`ve had the budget people and the economists looking at what this benefit will mean for seniors. Mind you, this is a work in progress. We`ll keep tweaking it, but this is where we are.
The benefit would be a part of Medicare and everyone eligible for Medicare would have the option of having this coverage. It would be voluntary, but the number crunchers think that almost 95% of seniors would choose to have
the coverage.
The premium would be between $35 and $45 per month plus a nominal co-pay per prescription. Seniors with annual incomes less than 150% of the poverty level -- about $17,910 for a couple and $13,290 for a single person -- would not have to pay premiums. 70,000 seniors in New Mexico are under that income level and would qualify for the no-cost coverage.
After out of pocket expenses of $5000, all medicine would be paid for by the insurance, giving security to seniors who face serious illness and high drug costs.
The analysts also tell us that because of the advantages insured people have by buying in bulk, there would be immediate savings of 25% or more compared to what you would pay retail if you just walked into the pharmacy.
Every senior would have a choice of plans or pharmacies that work best for them -- including mail order or incorporation into their Medicare Choice plan.
While we are reaching consensus on the prescription drug plan, we are still engaged in serious negotiations about other changes to improve Medicare at the same time. We have some problems with payment rates and formulas for
hospitals, doctors, home health providers that need to be fixed. So far, I am concerned that the changes being proposed would benefit states who are already richly compensated under Medicare more than states like New Mexico, which is at the bottom of the scale. We are continuing to work towards more fairness in these "updates" and I`ll keep you informed.
Two years ago, the House passed a prescription drug benefit for Medicare and the Senate did not take the bill up. So, we had to start over again. This is an important issue and I hope that, this year, we pass it in the House and
the Senate moves forward as well.
It`s 95 degrees and 90 percent humidity in Washington this week. It`s hard to say, "wish you were here" in good faith under these conditions. Before air conditioning, everyone escaped Washington during the sweltering summer.
There`s something to be said for that!
Wish you were here,
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