NEWS RELEASE
Committee on Energy and Commerce Democrats
Congressman John D. Dingell, Ranking Member

National Donut Hole Day Today:
Loss in Drug Coverage to Affect Millions
of Medicare Beneficiaries

Today marks the day when it is estimated that the average Medicare beneficiary will begin losing coverage under the Medicare prescription drug program due to a gap in coverage known as the “donut hole.”

“During the short legislative window we had this month we should have been fixing the donut hole in the Medicare drug benefit instead of spending time talking about horses,” said Rep. John D. Dingell, Ranking Member of the House Committee on Energy and Commerce, which has primary jurisdiction over health issues including Medicare. “The few remaining days before we leave to campaign should be dedicated to addressing this problem.”

Under a standard Medicare prescription drug plan, a Medicare beneficiary receives coverage until the total cost of his or her prescription pharmaceuticals reaches the limit of $2,250. At this stage, the beneficiary must pay 100 percent of prescription drug costs for the next $2,850, until qualifying for catastrophic coverage. To make matters worse, the beneficiary must continue to pay monthly premiums during the period in which he or she receives no benefit.

This gap in coverage, or “donut hole”, was written into the Medicare drug law by Republican negotiators. Nearly 7 million seniors and people with disabilities who receive Medicare are estimated to have high drug costs and fall into this coverage gap. According to a recent report released by the Institute for America’s Future, today is the day that the average Medicare beneficiary will fall into the donut hole.

The prescription drug program became available to Medicare beneficiaries in January of this year and has been plagued with problems throughout its implementation and operation. Democrats have introduced legislation to address the continuing problems with the program including the Medicare Prescription Drug Savings and Choice Act of 2005 (Berry) which would provide savings by allowing Medicare to negotiate lower prices for prescription medicines and the Medicare Prescription Drug Emergency Guarantee Act (Dingell) which would provide emergency relief to those who are having trouble navigating the Medicare prescription drug program. The Republican-controlled House has refused to schedule hearings or markups on these bills or any other Democratic legislation to address the flaws in the Medicare Prescription Drug program.

“We know what the problems are. Seniors know what the problems are. If my colleagues on the other side of the aisle know there are problems, they are certainly not showing it,” said Dingell. “It is time to do what is right for seniors.”

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