And debating there was. The house passed the Medicare Prescription Drug and Modernization Act of 2003 after a wearisome three hour role call that ended at dawn. The final vote was 220 in favor and 215 opposed; while 16 democrats joined the 204 republicans in voting for the bill, 25 republicans and one independent joined the democrats in trying to defeat it. Reportedly, President Bush phoned the house chambers several times from Air Force One adding his “support.”
“I am proud that a bipartisan majority banned together in support of this legislation and didn’t allow ‘perfect’ to be the enemy of the good, Blunt said, adding that the bill was “good for seniors, good for families and good for the long-term viability of Medicare.”
But Rep. Jim McGovern (D-Mass.) called the bill a “huge giveaway to prescription drug companies and shoves Medicare down that path toward privatization.”
The legislation essentially gives 40 million older and disabled Americans a prescription drug benefit and new option for health care coverage. In 2004 it provides for the purchase of discount drug cards supposedly with savings of between 15 and 25% before the actual prescription drug benefit is in place in 2006.
It allows private insurance companies to establish new managed care plans for seniors, either in the form of PPOs or HMOs. Medicare currently includes an option for private coverage as a secondary payer.
But, it’s no wonder that drug and insurance companies are lobbying heavily for passage of the new legislation. The way the bill stands insurance companies that choose to provide a private alternative to Medicare would receive billions of dollars in subsidies to reimburse them at a higher rate.
Democrats clamor that the estimated annual premium of $420 diminishes the savings and that the no cost containment provisions for drug companies would eat up the rest. Senate Democratic leader Tom Daschle estimated that “25% of seniors would be worse off” and assumed that prescription drugs would be “more expensive or more difficult to obtain.”
In addition, Daschle called attention to the likely loss of drug coverage programs by former employees and the loss of access to existing Medicaid coverage for prescription drugs that current low income seniors enjoy.
While the legislation also would require seniors with annual incomes over $80,000 to pay higher premiums under Medicare Part B (coverage for services outside of the hospital), they would get a break if they were in the group being provided with new tax-deferred health accounts for helping to support high deductible insurance policies.
California republican Bill Thomas was the principal architect of the plan. You know what a mess California is in.
The fate of the plan now rests with 100 senators. We hope that they won’t be high pressured into passing Medicare legislation without ironing out some of its problems—problems that appear to make it quite far from “perfect.”
Here’s how southwest Missouri Congressman Roy Blunt believes the Rx drug benefit adds up for Missouri seniors:
- 888,126 beneficiaries in Missouri will have access to a Medicare prescription drug benefit—for the first time in history of the Medicare program—beginning in January 2006.
- 214,754 Missouri seniors will have drug coverage they would not otherwise have.
- Within six months after the bill is signed, Missouri seniors will be eligible for Medicare-approved prescription drug discount cards, which will provide them with savings 10-25% of the retail price of most drugs.
- $208,343,220 in additional help for 173,619 Missouri residents in 2004 and 2005: Beneficiaries with incomes of less than $12,123 ($16,362 for couples) who lack prescription drug coverage (including drug coverage under Medicaid) will get up to $600 in annual assistance to help them afford their medicines, along with the discount card.
- All 888,126 Medicare beneficiaries living in Missouri will be eligible to get prescription drug coverage through a Medicare-approved plan beginning in 2006. In exchange for a monthly premium of about $35, seniors who are now paying the full retail price for prescription drugs will be able to cut their drug costs roughly in half. In many cases, they’ll save more than 50 percent on what they pay for their prescription medicines.
- 269,141 beneficiaries in Missouri who have limited savings and low incomes (generally below $12,123 for individuals and $16,232 for couples) will qualify for even more generous coverage. They will pay no premium for their prescription drug coverage, and they will be responsible for a nominal co-payment (no more than $2 for generic drugs or $5 for brand name drugs).
- 62,241 additional low-income beneficiaries in Missouri with limited savings and incomes below $13,470 for individuals and $18,180 for couples will qualify for reduced premiums, lower deductibles and coinsurance, and no gaps in coverage.
- Additionally, Medicare, instead of Medicaid, will now assume the prescription drug costs of 144,468 Missouri beneficiaries who are eligible for both Medicare and Medicaid. This will save Missouri $658 million over 8 years on prescription drug coverage for its Medicaid population.