[Congressional Record (Bound Edition), Volume 155 (2009), Part 9]
[House]
[Page 12403]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           GUIDE ACT OF 2009

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from California (Ms. Roybal-Allard) is recognized for 5 
minutes.
  Ms. ROYBAL-ALLARD. Mr. Speaker, I rise to introduce the GUIDE Act of 
2009 on behalf of millions of vulnerable individuals known as dual 
eligibles, who are faced with critical and essential decisions on which 
drug plan and pharmacy will provide the medications they need to 
survive.
  Seven million Americans are duly enrolled in Medicaid due to low 
income levels and Medicare because of their age or disability. Almost 
40 percent are cognitively impaired. These are people with mental 
retardation, mental illness, autism and dementia. Over 75 percent have 
one or more functional limitations such as problems eating, bathing, 
dressing, and managing money.
  Prior to the passage of the Medicare Modernization Act, which 
established the Medicare part D prescription drug program, dual 
eligibles received their medications by simply taking their 
prescriptions and their Medicaid card to a pharmacy of their choice and 
paying a nominal fee.
  With the passage of part D, this simple process changed and dual 
eligibles were required to pick a plan from the new program or be 
automatically and randomly enrolled in one.
  Unfortunately, due to the life challenges faced by these cognitively 
impaired individuals, their attempt to navigate the array of complex 
prescription drug plans was overwhelming with regrettable consequences.
  Many mistakenly chose or were enrolled in plans that presented 
obstacles including: prohibited copays, limited formularies, and 
medication exclusions.
  Their lack of access to prescribed medications has been linked to 
serious adverse events, including increased emergency room visits and 
hospitalizations.
  To eliminate these access problems, I, together with the gentleman 
from Texas (Mr. Sessions), have introduced the Guidance, Understanding 
and Information for Dual Eligibles Act, or the GUIDE Act.
  The GUIDE Act addresses the life-threatening issue by establishing a 
pilot program where experienced social workers and case managers will 
provide dual eligibles with one-on-one counseling for Medicare part D 
in their community mental health centers and community nonprofit 
centers.
  This program will benefit this group of vulnerable Americans by 
ensuring tangible access to the medications they so badly need to live 
healthy and productive lives. In addition, this program will benefit 
all Americans by reducing the social and economic costs associated with 
lack of access to essential medications.
  Mr. Speaker, the GUIDE Act is an important bill that will provide one 
of the most vulnerable groups in our society with the information, 
guidance, and understanding they need to successfully choose the 
Medicare part D prescription drug plan that meets their health care 
needs for survival and a healthier and better quality of life.
  On behalf of the millions of cognitively disabled and mentally ill 
Americans who live in all of our districts, I strongly urge my 
colleagues to cosponsor and support the GUIDE Act.

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