[Congressional Record Volume 152, Number 90 (Wednesday, July 12, 2006)]
[Senate]
[Pages S7421-S7422]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DORGAN (for himself, Mr. Bingaman, Ms. Stabenow, Mr. 
        Lautenberg, Mr. Johnson, Ms. Mikulski, Mrs. Clinton, Mr. 
        Menendez, and Mr. Akaka):
  S. 3647. A bill to amend title XVIII of the Social Security Act to 
waive the monthly beneficiary premium under a prescription drug plan or 
an MA-PD plan during months in which an individual enrolled in such a 
plan has a gap in prescription drug coverage; to the Committee on 
Finance.
  Mr. DORGAN. Mr. President, nearly one-third of Medicare beneficiaries 
are going to become all too familiar with what is called the ``doughnut 
hole'' over the next several months. The doughnut hole is a gap in 
coverage that exists in most Medicare prescription drug plans.
  Here is how the doughnut hole works: Under most plans, Medicare will 
pay for 75 percent of drug costs up to $2,250 after an initial $250 
deductible. But then Medicare pays nothing until drug expenses exceed 
$5,100. During this gap in coverage, beneficiaries continue to pay 
monthly premiums but get no drug coverage at all. I think this is 
unfair.
  That is why I am introducing the Prescription for Fairness Act. This 
legislation is simple. It says seniors should not have to pay monthly 
premiums during the time when they have

[[Page S7422]]

no drug coverage. The legislation would waive the monthly premium for 
any month that a senior is trapped in the doughnut hole.
  The legislation will help people like Mrs. McLain, an 88-year-old 
woman who lives in a long-term care facility in Bottineau, ND. She 
enrolled in the Medicare prescription drug benefit earlier this year. 
Her brother, who helps pay her health care bills, was recently 
contacted by their local pharmacist. The pharmacist explained that Mrs. 
McLain no longer has Medicare drug coverage and must pay about $500 
every month for her diabetes medications. This is not an expense that 
they had planned for, nor one they can afford. They did not realize 
that this coverage gap existed when they enrolled in the plan. This is 
one of countless stories that we will hear over the next several months 
as seniors fall into this coverage gap.
  Some will say that beneficiaries trapped in the doughnut hole should 
have selected plans that provide better coverage. I think it is unfair 
to blame beneficiaries for selecting the wrong plan. A new report by 
the Government Accountability Office found that the call centers 
operated by the Medicare prescription drug plan sponsors only gave 
accurate and complete information to callers about one-third of the 
time. More than one in five callers received completely inaccurate 
information.
  It is worth noting that the Prescription for Fairness Act will have 
no affect on the bottom lines of the participating Medicare 
prescription drug plans. Under the legislation, the Secretary of the 
Department of Health and Human Services will simply pay the monthly 
premium on behalf of the beneficiary. It is offset by reducing the 
Medicare stabilization fund. This fund is completely unnecessary. It is 
a $10 billion pot of money that was added to the Medicare Modernization 
Act to provide bonus payments and incentives to managed care companies 
to enter the Medicare market. It is time that Congress provides a 
safety net for seniors, not health plans.
  This legislation merely provides seniors some relief in the short 
term. The legislation would expire after fiscal year 2008. This 
Congress still needs to close the doughnut hole. In October, I joined 
Senator Bill Nelson to introduce the Medicare Prescription Drug Gap 
Reduction Act, which would allow the Secretary of Health and Human 
Services to negotiate fair drug prices and the savings would be used to 
eliminate the doughnut hole. Believe it or not, the Medicare 
Modernization Act contained a provision that explicitly prohibits the 
government from using its market clout to negotiate for fair drug 
prices for our seniors.
  I am hopeful that the Senate will take up the Medicare Prescription 
Drug Gap Reduction Act. In the meantime, let's make sure seniors are 
not charged for a benefit that they are not receiving. The Prescription 
for Fairness Act does just that.
  I am pleased to be joined by Senators Bingaman, Stabenow, Lautenberg, 
Johnson, Mikulski, Clinton, Menendez and Akaka in introducing this 
important legislation. I am also pleased that Families USA has endorsed 
this legislation.
  I ask for unanimous consent that a copy of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3647

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Prescription for Fairness 
     Act of 2006''.

     SEC. 2. WAIVER OF MONTHLY BENEFICIARY PREMIUM DURING COVERAGE 
                   GAP.

       (a) In General.--Section 1860D-13(a) of the Social Security 
     Act (42 U.S.C. 1395w-113(a)) is amended by adding at the end 
     the following new paragraph:
       ``(7) Waiver of monthly beneficiary premium during coverage 
     gap.--
       ``(A) In general.--During the period beginning on the date 
     of enactment of the Prescription for Fairness Act of 2006 and 
     ending on September 30, 2008, in the case of an individual 
     enrolled in a prescription drug plan or an MA-PD plan which 
     does not provide any coverage of benefits after the 
     individual has reached the initial coverage limit under 
     paragraph (3) of section 1860D-2(b) and before the individual 
     has reached the annual out-of-pocket threshold specified in 
     paragraph (4)(B) of such section, the following rules shall 
     apply:
       ``(i) The individual is not responsible for payment of the 
     monthly beneficiary premium (as computed under paragraph (2) 
     and adjusted under paragraph (1)) under such a plan for any 
     month during which such coverage is not provided.
       ``(ii) The Secretary shall provide for payment of such 
     monthly beneficiary premium under such a plan on behalf of 
     such an individual for any month described in clause (i). 
     Such payment shall be made from the Medicare Prescription 
     Drug Account.
       ``(B) Refund of premiums paid.--In the case of such an 
     individual who pays the monthly beneficiary premium under 
     such a plan for a month during which such coverage is not 
     provided, the Secretary shall refund an amount equal to the 
     premium paid. Such refund shall be made from such Account.''.
       (b) Conforming Amendments.--Section 1854(b)(1) of the 
     Social Security Act (42 U.S.C. 1395w-24(b)(1)) is amended--
       (1) in subparagraph (A), by inserting ``and, if applicable, 
     the waiver under subparagraph (D)'' after ``subparagraph 
     (C)''; and
       (2) by adding at the end the following new subparagraph:
       ``(D) Waiver of ma monthly prescription drug beneficiary 
     premium.--During the period beginning on the date of 
     enactment of the Prescription for Fairness Act of 2006 and 
     ending on September 30, 2008, the provisions of section 
     1860D-13(a)(7) shall apply to the MA monthly prescription 
     drug beneficiary premium in the same manner as they apply to 
     the monthly beneficiary premium under such section.''.

     SEC. 3. REDUCTION OF MEDICARE ADVANTAGE REGIONAL PLAN 
                   STABILIZATION FUND AMOUNT.

       (a) In General.--Section 1858(e)(2) of the Social Security 
     Act (42 U.S.C. 1395w-27a(e)(2)) is amended--
       (1) in subparagraph (A)(i), by striking ``There shall'' and 
     inserting ``Subject to subparagraph (E), there shall''; and
       (2) by adding at the end the following new subparagraph:
       ``(E) Reduction in initial funding to offset cost of waiver 
     of prescription drug premium.--The Secretary shall reduce the 
     amount available under subparagraph (A)(i) by an amount equal 
     to the Secretary's estimate of the increased expenditures 
     from the Medicare Prescription Drug Account by reason of the 
     amendments made by section 2 of the Prescription for Fairness 
     Act of 2006.''.
       (b) Effective Date.--The amendments made by this section 
     shall take effect as if included in the enactment of section 
     221(c) of the Medicare Prescription Drug, Improvement, and 
     Modernization Act of 2003 (Public Law 108-173; 117 Stat. 
     2181).
                                 ______