A REAL Prescription Drug Bill
Our seniors are treasures and to ignore their needs is a national disgrace. David Ashe will work to pass a Medicare Prescription Drug Bill one that gives real benefits and does not simply feed the greed of HMO???s and insurance companies. The current law that was passed by this Congress is described as ???the best we can do for now.” The bottom line is that the benefits to seniors is minimal but the benefit to HMOs and insurance companies is enormous. HMO???s and insurance companies will now collect billions in federal money.
Keep in mind that in the current prescription drug plan, the Department of Health and Human Services is not allowed to negotiate with HMOs for the cost of these prescription drugs. For example, the prescription drug card provides a 20% discount to seniors when they buy prescription drugs. However, there is nothing to stop companies from simply raising prices 20%. This law also does not allow our Seniors from paying less by receiving their medication from Canada where prices are lower.
In addition, even the best-case benefits to seniors are too small. Take a look at the examples below:
(1) A senior with $2,250 in drug costs in a year will pay:
- $420 in premiums ($35 each month x 12)
- $250 deductible
- $500 which is 25% of drug costs from $251 to $2,250
Senior???s cost: $1,170 for $2,250 in drugs.
- This senior pays more than 50% of their drug costs.
(2) Now, consider the senior whose drug costs fall above $2,250 and are therefore in the ???donut hole??? where they must pay 100% of the cost.
Let???s say this senior has $3,500 in annual drug costs. This does not exceed the $5,100 total drug cost threshold necessary to trigger the near-catastrophic coverage. They will pay:
- $1,170 for the first $2,250, as noted above
- $1,250 which is 100% of the difference between $2,250 and $3,500
Senior’s cost: $2,420 for $3,500 in drugs.
- This senior pays 70% of the cost.
(3) A senior with $5,500 in drug costs each year would reach the near-catastrophic trigger because they have total drug costs above $5,100. They will pay:
- $1,170 for the first $2,250 as noted above
- $2,850 for 100% of cost in the donut hole ($5,100-$2,250 = $2,850)
- $20.00 which is 5% of $400 (the difference between $5,100 and $5,500)
Senior???s cost: $4,040 for $5,500 worth of drugs.
- This senior pays 74% of the cost.