House Democrats Propose New Medicare Prescription Drug Benefit Bill
A group of 18 moderate House Democrats yesterday proposed a Medicare prescription drug benefit that would be added to the existing program and would only apply to beneficiaries with low incomes or high drug costs, the New York Times reports. Under the plan, sponsored by Reps. Cal Dooley (D-Calif.) and Rahm Emanuel (D-Ill.), Medicare would pay 80% of the cost of each prescription after a beneficiary has incurred $4,000 in drug costs in a year. Further, the plan calls for the federal government to cover a percentage of drug costs for beneficiaries with annual incomes less than 200% of the federal poverty level, or $17,960 for an individual, on a sliding scale based on income. For instance, the government would cover 80% of drug costs for beneficiaries with the lowest incomes and a decreasing portion as beneficiaries' incomes rise. The $4,000 deductible would not apply to beneficiaries with incomes below 200% of the poverty level. Dooley and Emanuel said the drug benefit, which would have no extra premium, could be delivered through HMOs, group health plans for retirees, private insurance polices or state drug assistance programs. According to the Congressional Research Service, almost 50% of seniors have annual incomes of less than 200% of the federal poverty level, and the Congressional Budget Office says that 17% of seniors will have drug expenses higher than $4,000 this year, the Times reports. The bill also calls for the government to negotiate medication discounts with drug companies and then create drug discount cards that could save beneficiaries 15% to 30%. The bill would cost $400 billion over 10 years, the same amount that President Bush has requested for Medicare reform and a drug benefit in his fiscal year 2004 budget outline.
Dooley said that other Medicare drug benefit proposals by Republicans and Democrats have "serious shortcomings" because the drug benefits they propose generally would be optional and would charge beneficiaries additional premium costs. He said that such approaches would attract a disproportionate number of sick people who will need a large number of prescription drugs. Dooley and Emmanuel said that Democrats should support their plan because it would not privatize Medicare or require "sweeping changes" in the program's structure and that Republicans should support it because its cost is limited and it would not "lavish aid" on the wealthy, the Times reports. "Our proposal is fiscally and politically realistic," Dooley said. Howard Bedlin, vice president of the National Council on the Aging, said, "This is not the ultimate solution, but it would be a good start, a potential compromise, that could attract bipartisan support if we find there's not enough money to provide more comprehensive drug benefits." Members of both parties said that Congress might eventually support such a plan if legislators cannot agree on a plan to give a drug benefit to all Medicare beneficiaries, the Times reports (Pear, New York Times, 4/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.