The elderly and disabled have waited long enough for a prescription drug benefit in Medicare and for relief from the high cost of prescription drug prices.  House Democrats are committed to providing a comprehensive benefit that is affordable and dependable for all beneficiaries with no gaps or gimmicks in coverage.  This benefit will be similar to what seniors and individuals with disabilities get in Medicare now.  What we offer senior citizens and individuals with disabilities should be no less generous than what Members of Congress and other Federal employees receive.

The House Democratic proposal adds a new Part D in Medicare that provides voluntary prescription drug coverage for all Medicare beneficiaries beginning in 2005.

  Premium:   $25 a month

   Deductible:  $100 a year

   Co-insurance:  Beneficiaries pay 20%; Medicare pays 80%

Out-of-pocket limit: $2,000 out-of-pocket limit per beneficiary per year

  Low-income:   Beneficiaries with incomes up to 150% of poverty
                             pay no premium or cost-sharing. Beneficiaries
                             with incomes between 150 - 175% of poverty pay
                             no cost-sharing and receive assistance with the
                             Part D premium on a sliding scale.

But even with a Medicare drug benefit, seniors and the disabled want the assurances that they won’t be overcharged and they don’t want the Medicare program to be overcharged. That’s why Medicare contractors will obtain guaranteed reductions in prices, and the HHS Secretary will have the authority to use the collective purchasing power of Medicare’s 40 million beneficiaries to negotiate lower drug prices – just like he did successfully with Cipro in 2001.  In addition, the proposal reduces drug prices for everyone by stopping big drug company patent abuses.  The Secretary could also implement measures that will further reduce costs and improve quality for beneficiaries such as: encouraging use of generic drugs, lowering co-insurance for preferred drugs, disease management, and beneficiary and provider education.  Medicare would also require contractors to put in place safeguards to check for adverse drug interactions and proper use of medications.

Under the Democratic plan, seniors and individuals with disabilities will be able to keep making the choices that matter.  Seniors won’t have to join an HMO to get drug coverage.  Nor will they be forced to join a private insurance plan that will restrict access to needed drugs, deny coverage for the medicine their doctor prescribes, or force them to change pharmacies.  Democrats will ensure seniors will always be able to obtain the drugs their doctor says they need at reduced prices and will be able to choose where to fill their prescriptions.