[Congressional Record (Bound Edition), Volume 151 (2005), Part 20]
[Senate]
[Page 27279]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   MEDICARE PRESCRIPTION DRUG BENEFIT

  Mrs. BOXER. Mr. President, last Tuesday the open enrollment period 
for the Medicare Part D prescription drug program began. This program 
has been praised by the administration as a great benefit for seniors, 
but I can tell you that seniors are not so sure. According to a survey 
conducted by the Kaiser Family Foundation, only 20 percent say they 
will sign up. Over one-third say they won't, and the rest don't know 
what they are going to do.
  One thing we do know for sure is that seniors are confused and 
scared. I have received over 4,000 letters from them telling me so. And 
why wouldn't they be. They have a series of complicated decisions to 
make.
  First, they have to decide whether they want drug coverage. Do they 
already have drug coverage that is better or just as good as what is 
offered under the plan? And if they don't, do the costs of the plan 
exceed the benefits? And what will happen in the future? Should they 
sign up now to avoid the penalty for signing up late?
  Second, if they do decide to join the program, what plan do they 
choose? In California, 18 companies are providing 47 stand-alone 
prescription drug plans. These plans all have different premiums, 
copays, and lists of drugs they will cover. For those in managed care 
plans, if they choose one of the stand-alone drug plans instead of 
their managed care plan, they will lose their health coverage.
  In addition, seniors must make sure that their neighborhood pharmacy 
accepts the plan. Otherwise, they will end up having to find a new 
pharmacy that is probably less convenient. And after all that, any plan 
can--on 60 days notice--change the list of drugs it covers. Seniors, 
however, can change their plans only once a year.
  If seniors do choose to participate, the benefit itself is meager. 
There is a large coverage gap--the so-called donut hole--so seniors 
must pay 100 percent of drug costs once they spend $2,250 and before 
they spend $5,100. Moreover, there is nothing in the program that will 
actually lower the cost of prescription drugs, and, in fact, Medicare 
is expressly prohibited from negotiating for lower prices.
  Mr. President, the seniors who are the sickest and poorest have the 
most to lose with this new program. Those 6.1 million seniors are 
eligible for both Medicaid and Medicare. They are known as dual 
eligibles. Currently, State Medicaid programs cover their drug costs, 
but as of January 1, they will be switched to the less generous 
Medicare program, and the States will be prohibited from using Medicaid 
to provide better coverage.
  We need to make changes to the program now so that our seniors do not 
suffer. That is why I am a proud cosponsor of several bills that will 
change the harshest parts of this program. We must allow Medicare to 
negotiate on behalf of seniors for lower drug prices. We must allow 
States to use Medicaid to improve the drug coverage of the sickest and 
poorest seniors. We must end the coverage gap for all seniors. We must 
allow seniors more time to understand the program before they are 
required to enroll.
  Mr. President, these changes are needed--and needed now. Without 
them, the promise of a Medicare prescription drug benefit may turn out 
to be a hollow one.

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