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Jul-20-2006 16:21printcomments

Snowe-Wyden Urge Senate Leadership to Confront Looming Medicare Donut Hole

Senators Introduce Legislation Providing Relief to Those Who Will Experience a Gap in Coverage; Believe Price Negotiation Should Be Used to Fill In the Donut Hole.

Photo by: Tim King

(WASHINGTON, DC) - In anticipation of millions of seniors facing a potential gap in Medicare prescription drug coverage, known as the “donut hole,” Ron Wyden (D-Ore.) amd U.S. Senators Olympia J. Snowe (R-Maine) today introduced legislation, the Medicare Prescription Drug Lifeline Act, to ensure that seniors do not fall into the “donut hole” of Medicare prescription drug coverage by alerting seniors when they approach coverage limits (the donut hole) and allowing them to switch plans to avoid the gap.

At the same time, the Senators also renewed their pledge to push for passage of legislation to bring down drug costs through price negotiation for Medicare prescription drugs; the savings achieved could then also be used to close the coverage gap. Both Senators are members of the Senate Finance Committee, which has jurisdiction over Medicare.

Snowe and Wyden believe price negotiations for Medicare prescription drugs must be utilized as a means of filling in the donut hole, and have called upon the Senate leadership to take up the issue before the Senate adjourns.

For the first time in Senate history, Snowe and Wyden last March successfully secured majority Senate support (54 - 44) for a provision paving the way for the Secretary of Health and Human Services (HHS) to negotiate for the best price on Medicare prescription drugs.

“This year our nation’s seniors are facing a confluence of challenges - the highest first quarter brand name prescription drug price increase in the last six years and a potential gap in drug coverage under Medicare. The solution lies with the Senate moving forward with two pieces of legislation that we have authored.

The first allows the Secretary of HHS to negotiate for Medicare prescription drugs, which will help us fill the donut hole.

The second, that we are introducing today, allows seniors to switch to a plan so they are not faced with skyrocketing drug costs when they fall into the coverage gap,” said Snowe. “Now is the time for the Congress to act, before it is too late, so our nation’s seniors will not have to choose between their life-saving medication and the food on their table.”

“Seniors who enter the donut hole -- the ‘no man’s land’ of spending on prescription drugs -- face the same problems seniors faced before the drug benefit even began: they skip doses, they don’t take all their medicine to make it stretch, and they are forced to choose between their food and fuel costs and their prescription drug costs,” Wyden said. “Through this legislation, Senator Snowe and I are working to provide a literal lifeline for seniors before they fall into the Medicare drug coverage gap. We are also continuing to fight for a common-sense approach to holding down costs through bargaining power for seniors’ prescription drugs.”

According to the Kaiser Family Foundation, nearly seven million seniors are expected to fall into the “donut hole” in 2006. The Snowe-Wyden legislation introduced today, the Medicare Prescription Drug Lifeline Act, would give seniors the security of having continued coverage of their essential medications.

Under this legislation, every senior would be warned as they approached the “donut hole” and would be provided an opportunity to switch to another plan to continue drug coverage. The legislation also directs the Government Accountability Office to undertake a study of ways by which the coverage gap may be eliminated, including eliminating the gap without increasing federal spending.

Under the new prescription drug program, Medicare beneficiaries receive up to 75 percent coverage of drug expenses until drug spending reaches $2,250 in a year. Then under most plans, a beneficiary bears the full brunt of drug costs until spending reaches $5,100 in total drug costs.

That leaves a coverage gap – the “donut hole”- of $2,850 that seniors with serious prescription needs are expected to manage on their own. Yet current law prevents plan changes by most beneficiaries, leaving many facing the same dilemma they faced before – skipping doses, or reducing the number of medications they take.


Comments are Closed on this story.

Victor July 21, 2006 7:09 am (Pacific time)

I work at a Canadian Pharmacy, we are helping many people who are hitting the donut hole. Call 1 877 278 3242 for more Information.

Oldie July 20, 2006 9:45 pm (Pacific time)

Humana Complete does not have a donut hole. However, all part D Medicare plans exclude the bezodiazepines, like valium, xanax, clonazepam, and at least 10 others. There is a bill to remove the exclusion of the benzo's... H.R. 3151. Write to your Congress people to have this class of drugs included.

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