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Legislative Update Week of December 8, 2003
TREA Senior Citizens League (TSCL) has long been advocating the establishment of a prescription drug benefit for seniors. The bill signed into law on Monday, December 8, 2003, is far from perfect, but TSCL believes it is a first step -- a step that we can build upon in order to provide better quality of life for our seniors. Read the full TSCL position paper below. TSCL’s Position on the Medicare Prescription Drug Compromise, H.R.1 The decision by TSCL to support H.R. 1, the prescription drug compromise recently announced by conference committee members, is not an easy one. As pretty much everyone has said all along, this bill is not going to completely please anyone. No one is going to get everything that they want. That’s what compromise is all about. TSCL has been advocating a prescription drug benefit for quite some time, because our members have asked us to. Does this bill have everything that our members and supporters will want? No. However, we have come to the conclusion that this bill appears to have the opportunity to help those who need it most, and that it is worth the effort to try to implement a prescription drug benefit. As many of our supporters know, we have pushed very hard in recent months on behalf of a measure to allow for reimportation of prescription drugs from Canada and Europe. Unfortunately, the prescription drug compromise language would only allow reimportation from Canada, and then only if the Secretary of Health and Human Services would assent to it, saying that there was no greater risk to Americans from taking those drugs that were imported. That’s not going to happen. In the House of Representatives, a separate bill -- introduced by Congressmen Gil Gutknecht and Rahm Emanuel - that would allow importation from Canada and many European countries, passed by an overwhelming margin of 243-186. In late October, Senator Byron Dorgan of North Dakota introduced a companion measure in the Senate. Senator McCain, Chairman of the powerful Commerce Committee, is a cosponsor of the measure and has held a hearing on the issue. While we were gravely disappointed with the lack of strong importation language in the compromise prescription drug bill, we believe that the issue of reimportation may have enough momentum to pass as a separate bill. We are certainly going to continue our efforts to see that that happens. Under the compromise prescription drug bill -- as we understand it -- if general tax revenues account for more than 45% of Medicare spending, there would have to be a consideration for cost-control mechanisms. There is a concern that this could mean a reduction in benefits or an increase in premiums. However, it is possible at any time that -- in order to keep Medicare solvent -- benefits would be cut or premiums increased. And the requirement is only for a consideration of cost-control mechanisms; it is not binding. While we are pleased that dual-eligibles -- those individuals who are eligible for both Medicare and Medicaid -- will receive their prescription drugs through Medicare, we are concerned about the cost that dual-eligibles will be charged for prescriptions. The initial $3 that the dual-eligibles will be charged will rise, but whether the increase in cost will be tied to Medicare spending or consumer prices, remains to be seen. Tying the increases to Medicare spending would mean great difficulty for seniors. Too, the increase in Medicare Part B, set at $110 in 2005 is acceptable, but indexing its growth to growth in Part B expenditures is very troubling. Premium support, or competition between private plans and Medicare -- is of concern. Some argue for greater market forces. The bill is scaled back from some early talks, to call for testing of premium support. While we would rather not have inclusion of premium support in the bill, the fact that it includes a demonstration program rather than a call for full implementation, gives us an opportunity to study the issue further. Seniors who are better off are likely to have to pay higher Part B premiums, based on a sliding scale. The way this will be indexed in the future is unclear, and again cause for some reluctance. The compromise legislation includes a fallback plan, so that at least one prescription drug plan and one combined (prescription drug plan and health benefit) plan will be available in each region. We believe this was essential to the bill. Employers are provided with incentives to retain coverage for their employees. This was an important issue for TSCL, and one on which we lobbied Members of Congress. While the incentives provide no guarantee, we believe they will be helpful in encouraging employers to do the right thing by their employees. Rural areas are assisted, both in the fallback plan and through additional funding for rural hospitals. There will be no copayment for home health care, an area earlier on the table for discussion. Finally, new preventive benefits will be made part of Medicare, including screening for diabetes and cardiovascular disease; as well as a disease management program. If we don’t pass a prescription drug plan, the next opportunity may be far in the future. Those seniors, who are getting by on a shoestring now, can’t wait another several years for assistance. If this plan doesn’t work, we can go back and try again. TSCL will continue its efforts to see that drug importation -- something that will, we believe, lower the cost of prescription drugs -- is enacted. And we will carefully monitor how the prescription drug legislation affects our members and supporters. We have asked Congress to act on a prescription drug benefit for quite some time. After months of negotiations and after years of broader discussions, a package has been crafted. Let’s not use scare tactics to dismantle it. Rather, let’s see that seniors are given an opportunity for better access to affordable health care and a better quality of life. December 2003 | ||||||||
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