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Washington, D.C. - After seniors battled months of confusing and inaccurate enrollment information surrounding the Medicare Prescription Drug program, the House Ways and Means Committee today released a Congressional Report that shows that 299,396 seniors and disabled workers in California -- 79% of newly enrolled Medicare Part D beneficiaries -- are at risk of falling into the doughnut-hole, the part of the program that contains a gap in coverage where beneficiaries continue to pay premiums without receiving financial coverage for medicines. Nationwide, 88% are at risk. The report also concluded that only 20,263 new enrollees gained full, uninterrupted coverage through the new law and that those beneficiaries paid a high price, premiums that were 270% higher, to get full coverage.
As this report shows, the opportunity to purchase plans that fill the hole is a mirage, said Rep. Howard Berman. Beneficiaries are no more able to afford expensive, full-coverage plans than minimum wage Americans are able to afford a new Cadillac."
The California Doughnut-Hole Report:
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An alarming 79 percent - 299,396 - of Medicare Prescription Drug plan enrollees* in California are enrolled in prescription drug plans that contain a doughnut-hole, or gap in coverage;
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Only 5.3 percent of California's new Medicare Prescription Drug plan enrollees* - 20,263- are enrolled in plans with full, uninterrupted coverage;
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Of the 47 plans available in California, 87 percent, 41 plans, have a gap in coverage;
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Californians enrolled in full coverage plans, without a gap in coverage, have to pay 2.7 times more in premiums than those in plans that have a gap;
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The average annual premium for a full coverage plan is 995.55.
"The donut hole will reduce protection against drug expenses just as many of those Medicare beneficiaries who are most in need are expecting financial relief," said Berman. "I'm guessing that many of those beneficiaries will be quite angry once they understand these rules."
Democrats have offered an alternative plan to fix the new Prescription Drug program. In the Democratic Prescription for Change, House Democrats have proposed making the Medicare drug benefit simple, affordable, and reliable for senior citizens and people with disabilities. Under the proposal, Medicare would be required to use its bargaining power to negotiate lower drug prices, and the savings would be used to fill the doughnut hole. The Democratic plan would also waive the late enrollment penalty for millions of beneficiaries who are now locked out of coverage until 2007, and simplify the program by creating a Medicare-sponsored option.
Click here to find a copy of the House Ways and Means Committee Doughnut-Hole Report.
*Percentages are of Medicare beneficiaries that are not eligible for low-income subsidies through Medicare or Medicaid when they enter the gap in coverage |
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