[Congressional Record Volume 152, Number 96 (Thursday, July 20, 2006)]
[Senate]
[Pages S8062-S8063]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself and Mr. Wyden):
  S. 3703. A bill to provide for a temporary process for individuals 
entering the Medicare coverage gap to switch to a plan that provides 
coverage in the gap; to the Committee on Finance.
  Ms. SNOWE. Mr. President, I am pleased to be here today with my 
colleague and friend, Senator Wyden, with whom I have worked for many 
years to achieve affordable prescription drug

[[Page S8063]]

coverage for our seniors. We have certainly come a long way from back 
where we were nearly 10 years ago.
  Yet much remains to be done. As we have seen, the implementation of 
the Medicare Part D benefit has been difficult, and there is no doubt 
we are still on the road to a sustainable benefit which our seniors can 
easily navigate. The complexity of the benefit is certainly posing a 
hazard to many of our seniors.
  Today we face a crisis as millions of seniors are entering a gap in 
their prescription drug coverage--the so-called doughnut hole. In fact, 
when a senior's drug costs exceed $2,250 this year, they will no longer 
receive benefits until their spending reaches $5,100. That leaves 
seniors with a full $2,850 of drug costs to absorb before they receive 
a single cent of coverage. And they must continue to pay premiums. The 
Kaiser Foundation has reported that an estimated 7 million seniors will 
be affected by this coverage gap. How will they continue to receive 
essential medications?
  Earlier this year, I offered legislation which would have addressed 
this issue by allowing every beneficiary to change their plan once this 
year so that those beneficiaries who realized that they require a more 
comprehensive plan could choose to change to an appropriate plan. We 
know that selecting drug coverage was a challenging process for 
seniors, all the more so as the deadline loomed and they struggled to 
get assistance.
  Many may have made a good decision, but their circumstances may have 
since changed significantly. How many of us know of a senior who has 
had a major illness or hospitalization just since January? Most seniors 
in that situation will have changes in their medications as a result 
and often will use more prescription drugs and likely more expensive 
ones as well.
  Finally, with coverage available, there is little doubt that 
physicians were encouraged to prescribe medications that at last their 
patients could afford--drugs which could prevent serious illness, such 
as heart disease. Yet now, just as seniors see the possibility of a 
future with better health, the cost of that critical treatment may be 
unsustainable. So millions are facing the dilemma we have seen before--
cutting doses or even discontinuing medications. This must not occur 
again.
  As many medical experts will tell you, to stop taking essential 
medications or to begin rationing their use will pose serious safety 
risks to many of our beneficiaries. That undermines the benefits we 
should see from Part D--improved health and decreased health 
expenditures.
  So Senator Wyden and I are here to offer a solution--one which, I 
might add, both HHS Secretary Michael Leavitt and Dr. Mark McClellan, 
the Administrator of the Centers for Medicare and Medicaid Services, 
have previously suggested they would pursue. That solution is a simple 
one--to allow those facing a coverage gap to change to a plan which 
would offer continuous coverage. That solution has simply not been 
employed and that compels us to act today, to protect our seniors.
  The bill I rise to introduce today--the Medicare Prescription Drug 
Lifeline Act--truly gives a second chance to those who most need this 
coverage. Under this legislation we require that CMS notify those who 
are approaching the coverage gap and give them an option of making a 
one-time plan change in order to obtain essential drug coverage. Under 
our legislation, beneficiaries could change to any plan which would 
provide continuous coverage. That includes drug plans which provide 
generic or brand-name drugs as well as Medicare Advantage plans 
offering comprehensive drug coverage.
  In a few States, there is simply not an option which allows a 
beneficiary to obtain continuous brand-name drug coverage. I note that 
in my State of Maine, as well as in New Hampshire and Alaska, such 
coverage simply cannot be obtained. So this legislation directs the 
Secretary to provide an option for beneficiary enrollment in a plan 
with brand-name drug coverage outside their region. That is simply 
fair, and it is essential to ensure that we don't see the doughnut hole 
threaten the health of our seniors.
  We know that this coverage gap is an issue we simply must address. 
Seniors need to be able to plan and budget and count on a predictable 
monthly cost for their essentials of life. When the Congress adopted 
Part D 3 years ago, we said we never wanted to make seniors again 
choose between buying food and buying essential medicines. Yet without 
addressing the doughnut hole now, we will put seniors in that exact 
position again.
  So this legislation also asks the GAO to undertake a study of options 
for eliminating the doughnut hole--looking at ways to level the benefit 
structure--including how we might do so without increasing federal 
expenditures. I note that one might be able to accomplish this, without 
changing the beneficiary's copayment rates appreciably. Obviously, if 
we saw some improvement in the pricing of drugs, that certainly would 
help get us there.
  Today our most critical need is to avoid the harm this coverage gap 
poses, and I call on my colleagues to join us in this effort--to 
preserve drug access for our seniors so both they, ad our Medicare 
system, realize the benefits of modern medicine.
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