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Sunday, Jun 24, 2018
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Medicare Part D needs to be preserved for seniors

Medicare Part D is a wonderful program that protects the health of our deserving seniors in Florida and throughout the nation. Recent proposed changes would be detrimental to seniors who rely on Part D for the medications they desperately need. We need to preserve it for current enrollees and those it will help in the future. Since enacted, the program has exceeded cost-saving expectations and is widely loved by seniors. This outstanding program delivers needed treatments at a far lower cost than projected by the Congressional Budget Office. Part D costs are 45 percent lower than projected for the initial 2004-2013 forecast period, and CBO has continued reducing its cost projection. Spending estimates have been reduced by more than $100 billion each of the past three years, proving that seniors are getting tremendous value in a program that is consistently affordable. Additionally, average premiums for enrollees this year are far below original projections at about $30 monthly, which is less than the original estimates of $61. Most Medicare enrollees cannot afford an extra $50 or $100 in additional monthly expenses, so it is fortunate that the premiums for Part D remain low, ensuring their medicines are affordable. Not only is the program costing less than expected, but studies have shown that Part D decreases medical spending in Medicare. CBO estimates that a 1 percent increase in the number of prescriptions filled by enrollees would cause Medicare’s spending on services to fall by about one-fifth of 1 percent. Additionally, a study in the Journal of the American Medical Association found that the Medicare prescription drug program was followed by a $1,200 annual decrease in non-drug medical spending among those who previously had limited drug coverage. This reduction saved taxpayers $13.4 billion overall during the first full year of Part D.
Some have suggested this extremely successful and important program be changed to lower costs. However, any modifications to this program would not lower costs for seniors; instead, it would inhibit the program. When Part D was enacted, it included a non-interference clause that allows for the free market to negotiate the price of medications. It is for this reason that costs remain low. According to the nonpartisan CBO, if we allow the secretary of Health and Human Services to interfere in the private price negotiations between Medicare Part D plans and drug manufacturers and pharmacies in the program, we will not see cost savings. CBO also says that striking the non-interference clause will not yield significant savings unless the government also restricts access or fixes prices. Some also argue that the benefit should be changed to work like Veterans Affairs’ prescription drug benefit. However, many VA beneficiaries prefer to use other coverage for their medicines rather than rely on VA coverage because of its restrictive formulary. A recent study on the subject, conducted by the Lewin Group, found that of the most routinely prescribed drugs for seniors, 93 percent were covered by both of the two most popular Part D plans — compared to only 67 percent covered by the VA formulary. Additionally, the proposed Independent Payment Advisory Board would be detrimental to the program, dictating arbitrary budget cuts. The proposed board is not accountable to anyone, and it would function independently of any control by elected officials in violation of the principle of the democratic process. Any change to the Part D program that could result in cost increases for enrollees would be detrimental. If seniors are unable to pay for the critical medications they need, many will suffer. We need to protect the critically important program that saves the lives of so many here in our Sunshine State.

Austin R. Curry is the executive director of Elder Care Advocacy of Florida.

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