 |
| Wilson: Medicine help for NM Seniors Closer Than Ever |
August 28, 2003 |
| |
| Albuquerque, NM - Congresswoman Heather Wilson told Albuquerque seniors Thursday that a long-sought voluntary Medicare prescription drug plan that helps New Mexico seniors is now closer than ever. Wilson has long supported adding a prescription drug benefit to Medicare. Legislation doing that has passed in the U.S. House three times, but has never made it through the Senate-until now. Wilson says that could spell relief for New Mexico`s seniors whose health relies on miracle medicines.
"I`m optimistic that long overdue help with prescription drug costs will soon be on the way to New Mexico seniors," Wilson said Thursday in an Albuquerque town hall meeting with seniors. "The Senate has now passed a bill, and that`s more than we`ve had before. This is an important issue, and is something we`ve worked on for a while. We must have a prescription drug benefit in Medicare."
In June, Congress passed a prescription drug benefit that will help New Mexico`s 229,000 seniors who rely on Medicare. H.R. 1, the Medicare Prescription Drug and Modernization Act, passed the U.S. House while the Senate fashioned a similar but separate bill. Unifying the House and Senate bills is one of the the last legislative step for the provision.
"Medicare was crafted in 1965, and at that time, no one could have guessed the role that prescription drugs would play in the health care system 38 years later. At that time, spending on drugs made up just 1% of health care costs," Wilson said. "That figure is now upwards of 17%. If we were starting with a clean sheet of paper today, no one in their right mind would craft a health care system for seniors that excluded medicine."
The voluntary prescription drug benefit will be available to all Medicare beneficiaries, while 52% of New Mexico`s seniors, those at or below 150 percent of poverty, will receive extra help with prescription drug premiums under the house bill. A total of 104,000 New Mexico seniors will pay zero in premiums. These fully subsidized drug premiums are for beneficiaries below 135% of poverty, about 45 percent of New Mexico seniors.
Additionally, Wilson successfully added to the final House bill a provision that will level the playing field and equalize payments to doctors in rural states like New Mexico. The potential impact of Wilson`s provision is $2.5 million a year in our state`s health care system.
"We don`t pay into Medicare based on where we live, and we should not be denied access to health care based on where we live," added Wilson. "Medicare pays a physician less for their time in Albuquerque than they pay in Dade County, Florida or in Manhattan. That`s wrong and it makes it harder to keep doctors in New Mexico."
Prescription Drug and Medicare Modernization Act of 2003
DETAILS ON Rx DRUG BENEFIT
Voluntary Rx Drug Benefit Available to ALL Medicare Beneficiaries
· Entitlement under Medicare
· CBO and CMS Actuary predict universal participation
· Those who want to stay with their current coverage, may do so, and employers encouraged to continue retiree coverage by receiving some assistance
Prescription Drug Benefit:
· $250 deductible
· $251- $2,000: 80% coverage, 20% cost-sharing
· Catastrophic protection after $3,500 out-of-pocket (100% of costs covered)
· Affordable premium around $35 per month or about $1 a day
· Good front end benefit aids most seniors (median spending is $1,285)
Targets Resources to Those Who Need It Most
· Fully subsidized premium and cost-sharing up to 135% of poverty, phasing out at 150% of poverty
* Medicare is primary payor and state governments receive assistance by phasing out their Medicaid prescription drug obligations over a number of years
* Low-income beneficiaries pay up to $2 per generic and $5 per brand name drug, per prescription
* High-income beneficiaries (individuals with incomes of $60,000 or couple with incomes of $120,000) have a higher catastrophic benefit
Beneficiaries Choose Plan that is Best for Them
* Choice of at least 2 plans guaranteed
* Competition holds down costs
* Choice of any pharmacy
DETAILS on MEDICARE MODERNIZATIONS
Quality Improvements to Enhance Seniors` Health
* Protections against adverse drug interactions
* Electronic prescribing to minimize medical errors
· Pharmacy therapy and chronic care management for beneficiaries with chronic conditions
Long Overdue Modernizations
· Covers an initial physical, cholesterol screening, and offers disease management
· Rural relief package for underpaid rural hospitals, physicians, and home health
· Revitalizes private plans in Medicare, followed by competitive bidding in which seniors can reduce their premiums
· Adds the President`s regional private Enhanced Fee-for-Service and PPO plans
· Enrolls 48 percent of beneficiaries in competitive private plans, according to CMS Actuary
· Initiates FEHBP-style reform in 2010
· Bipartisan regulatory relief and contractor reform
· Competitive bidding for durable medical equipment
· Reforms pricing for drugs administered by physicians, and adequately reimburses oncologists
-END- |
|
|
|