House Dems: Health reform bill would close Medicare "doughnut hole"

Oct 26 2009

CQ Politics: "House Speaker Nancy Pelosi made another bid to solidify support for Democrats' ambitious health care plans Friday, pledging to move aggressively to close the "doughnut hole" in Medicare drug coverage. Pelosi said the legislation she is negotiating with members of her caucus will give Medicare recipients who fall into the coverage gap an immediate 50 percent discount on brand-name prescriptions and shrink out-of-pocket costs by $500. The doughnut hole would be completely phased out by 2019, she said. ... She didn't say how much the new Part D plan would cost."

"Nancy A. LeaMond, executive vice president at AARP, said 26 percent of Medicare recipients enrolled in Part D plans fall into the doughnut hole each year in 17 states"  (10/23)

Bloomberg reports that the coverage gap "begins when elderly recipients amass a certain amount of drug expenses, currently $2,700. Coverage resumes after recipients pay all of the next $3,454 in drug costs. ... A PhRMA spokesman, the trade group that represents drugmakers and negotiated changes to the doughnut hole with the Obama administration, declined to comment on the latest proposal. (Rowley and Litvan, 10/24).

Reuters: "The emerging bill would also gradually eliminate the gap in prescription drug coverage in 10 years. The earlier version of the bill would have eliminated the gap in 15 years. ... Support from the elderly, who are more likely to vote in elections than other demographic groups, is crucial to enacting healthcare reform. Closing the doughnut hole could go a long way toward winning their support and is a top priority for the AARP, an influential advocacy group for the elderly. ... Healthcare reform legislation working its way through the Senate also includes provisions aimed at reducing the Medicare prescription drug coverage gap (Smith, 10/23).