December 29th, 2009

Philadelphia Inq report:

WASHINGTON – Six years after Congress added a prescription-drug benefit to Medicare, Democrats in the House and Senate are poised to make a central change that they and most older Americans have wanted all along: getting rid of a quirk that forces millions of elderly patients with especially high expenses for medicine to pay for much of it on their own.

The closing of an unusual gap in Medicare drug coverage – a gap that Republicans, when they controlled Capitol Hill and the White House, had insisted was needed for the government to afford the program – would “forever end this indefensible injustice for America’s seniors,” Senate Majority Leader Harry Reid (D., Nev.) said in announcing that the Senate would join the House in supporting the change.

But details of the change underscore that, for patients and the federal budget alike, the implications of the sprawling health-care bills are more nuanced than lawmakers’ talking points.

The Democrats and President Obama have been clear that the “doughnut hole,” as the gap is known, would disappear gradually over the next 10 years. They have not mentioned that Medicare patients would, according to House figures, face a slightly larger hole in coverage during two of the next three years than they do today.

Proponents say the government can afford to eliminate the gap because the pharmaceutical industry would pay for the phaseout. But less than half the $80 billion that drugmakers agreed to provide, under a summer agreement with Senate Democrats and the White House, would be used to help fill the gap, according to Senate Democratic aides.

Moreover, there are no budget forecasts far enough into the future to show how much the expanded drug benefit would cost the government once the gap is fully closed.

Click here to read full article