Disability Issues

MIAMI – Lawmakers have wooed seniors skeptical of the health care overhaul by emphasizing the plan would close the “doughnut hole” — a gap in Medicare drug coverage that can cost thousands of dollars a year.

But getting support for the entire overhaul from this powerful voting bloc has been difficult, despite Democrats repeated town hall meetings, interviews and congressional hearings.

Medicare Part D established a new prescription drug benefit in 2006. The doughnut hole was designed to reduce the overall cost of the program. An estimated 3.4 million seniors fall into it each year.

Most people never see the other side of the doughnut hole. They simply wait for New Year’s Day. The House health care bill would close the gap gradually until it’s eliminated in 2022.

There are about 39 million people aged 65 and older in the U.S. and they voted at a higher rate than any other age group in the 2008 election, according to the Census Bureau. The 40-million-member AARP has endorsed the House’s version of the bill, but voters aren’t yet sold on the plan.

The latest Kaiser Health Tracking Poll, released last month, found just 32 percent of those 65 and older believed passage of a health bill would leave them and their families better off, compared with 44 percent of respondents under the age of 65.

When asked about elements of the health overhaul plan that are “extremely” or “very” important, the doughnut hole was the No. 3 issue for Republicans, and No. 4 for both Democrats and independents.

http://news.yahoo.com/s/ap/20091204/ap_on_he_me/
us_health_overhaul_prescription_drugs

Tom Scully seems to think that Medicare Part D-Presciption Coverage is competitively priced. In 2010 the monthly premiums and annual deductibles are set to increase substantially from 2009. In 2010, the doughnut hole is only increasing by $130 which isn’t signiificant. Mr. Scully repeatedly states that Medicare Part D-Presciption Coverage is confusing but he pats himself on the back for having designed and implemented the program. A number of viewers who call in tend to differ with his point of view. He doesn’t appropriately answer a number of callers questions and dismisses callers who don’t share his political points of view.

My Medicare Part D Drug Coverage is through Humana with the PDP Enhanced plan. My year 2007 drug benefit premium was $19.80. My year 2008 drug benefit premium is $24.80. My year 2009 drug benefit premium is going to be $37.70.

From Year 2007 to Year 2008 represents a 25.25% increase in premium costs.

From Year 2008 to Year 2009 represents a 52.00% increase in premium costs.

From Year 2007 to Year 2009 represents a 90.40% increase in premium costs.

The doughnut hole for my plan is $2,500. Due to being up against the doughnut hole, I have joined H-E-B Pharxmacy ScriptSave drug plan to avoid passing through the doughnut hole thus incurring higher prescription costs. The initial fee was $5.00 to enroll in the plan. I have filled two generic prescriptions for a copypayment of $5.00 for each prescription through H-E-B Pharxmacy ScriptSave drug plan. The copypament for one of the prescriptions through my Humana PDP Enhanced plan would have been $240.00. Once I break through the doughnut hole of my Humana PDP Enhanced plan the copypayment for one of my daily prescriptions will go from $4.00 to $106.65 and another prescription copyment will go from $25.00 to $88.20.

A year ago, Congress patted theirselves on the back for of the supposed private sector health insurance competition driving down the Medicare Part D Drug Coverage premium costs. What isn’t being disclosed is that Congress subsidized the private sector health insurance companies to undertake Medicare Part D patients. Those subsidies are expiring and now the Medicare Part D Drug Coverage premium costs are skyrocketing.

Part of the drug costs increase within Medicare Part D Drug Coverage can be attributed to Representative Billy Tauzin, one of the most influential Republicans.

Representative Tauzin, R-La., former chair of the Congressional committee overseeing the passage of Part D, worked hard to prohibit Medicare from negotiating with drug companies to achieve lower prices for seniors.
  
Mr. Tauzin received a reported $2 million offer to head the Pharmaceutical Research and Manufacturers of America, the drug industry trade group that had billions at stake in the Medicare prescription drug legislation, which Mr. Tauzin helped shepherd on Capitol Hill.

American’s United communications director Brad Woodhouse called Part D a “sell-out to pharmaceutical manufacturers.” “Part D prohibits Medicare from using its bulk-buying power to negotiate lower drug prices and denies senior citizens the choice of a prescription drug benefit direct from Medicare,” said Woodhouse. “Part D is better for industry than it is for pharmacists, senior citizens or patients.”

It is no wonder why Congress has a low approval rating with the public.

Skyrocketing Medicare Part D Drug Coverage premiums are placing a financial burden on persons on Social Security Disability. In order to receive financial assistance for premium payments a disabled person has means testing through State Medicaid. In order to receive financial assistance for drug premium payments a disabled person is subjected to means testing through State Medicaid. In other words persons on Social Security Disability are being categorized with low income persons who aren’t disabled.

I am recommending that Congress direct Social Security and or Medicare to assist persons on Social Security Disability with Medicare Part D Drug Coverage premiums without being subjected to means testing.