Whitehouse seeks to close ‘doughnut hole’

WASHINGTON, D.C. – U.S. Sen. Sheldon Whitehouse, D-R.I., and two colleagues have introduced legislation to shrink the Medicare prescription drug “doughnut hole,” the gap built into the program during which beneficiaries have to pay for their drugs on their own.
Currently, Medicare pays 75 percent of initial drug costs up to $2,700 after a $295 deductible. Then the program pays nothing until the beneficiary has spent a total for the year of $4,350. After that, coverage resumes. The idea behind the gap was to reduce program costs and provide an incentive to spend less on medications while protecting the most seriously ill.
Because insurers are free to provide more benefits than the mandated minimum, several Medicare Part D plans now cover at least generic drugs during the gap, but most don’t.
In a news release, Whitehouse said he has encountered “countless seniors who are frustrated and confused by the Part D program, and don’t understand why our government isn’t doing more to meet their very real needs for prescription drug coverage that works.”
The legislation Whitehouse introduced, which has bipartisan support, would allow the Secretary of Health and Human Services to negotiate bulk discounts with drug makers on behalf of Medicare – a power that was specifically denied in the original Part D legislation.
Any savings would be applied to diminish the size of the coverage gap.
“I strongly believe Medicare should be empowered to negotiate drug prices,” Whitehouse said. “This is a common-sense fix that will lower seniors’ costs and give them added peace of mind.”
The measure is called the Medicare Prescription Drug Gap Reduction Act of 2009. To find out more, go to whitehouse.senate.gov.