Common Sense Reforms to Fix the Medicare Drug Benefit
Close the “donut hole”
In 2006, many seniors learned they have no coverage (under most Medicare Part D plans) for prescription drug expenditures between $2,251 and $5,100. This gap in drug coverage is what is known as the “donut hole,” and the gap will continue to grow. Under current law, the government is prohibited from negotiating fair drug prices for our seniors. But research shows that removing this prohibition will generate enough savings to close the donut hole. That is why Senator Dorgan joined Senator Bill Nelson (D–FL) to introduce the Medicare Prescription Drug Gap Reduction Act. This legislation would allow the government to negotiate fair drug prices and would eliminate the donut hole.
Provide seniors trapped in the donut hole with short–term relief
Since Congress has failed to close the donut hole, Senator Dorgan introduced the Prescription for Fairness Act to provide seniors trapped in this coverage gap with short-term relief. Under current law, seniors trapped in the donut hole continue to pay monthly premiums but receive no drug coverage. This legislation would waive the Medicare Part D premium for any month that a senior falls into the donut hole.
Waive the late enrollment tax for 2006
Most seniors who enrolled after the deadline were asked to pay a late enrollment tax. Senator Dorgan introduced the Medicare Enrollment Fairness Act with Senator Stabenow in May 2006 to eliminate this penalty for seniors that were eligible but failed to enroll in 2006.
Prohibit plans from dropping coverage of drugs during the year
In February 2006, Senator Dorgan joined several of his colleagues to introduce the Medicare Drug Formulary Protection Act. This legislation would prohibit prescription drug plans from dropping drugs from their formularies that were covered when seniors enrolled in the plan. In response to this legislation, the Centers for Medicare and Medicaid Services announced a new policy that will prevent plans from making these formulary changes.
Force plans to disclose any gaps in coverage
In November 2005, Senator Dorgan joined several colleagues to introduce the Medicare Prescription Drug Gap Disclosure Act. This legislation would require all Medicare drug plans to disclose to its beneficiaries any gaps in drug coverage.
Ensure seniors have accurate information about the plans
Senator Dorgan is concerned that the Administration has made this benefit far too confusing. For example, many of the plans are called “complete” despite the fact that most plans have a major gap in drug coverage. Senator Dorgan sent a letter in November 2006, to urge the Administration to take a number of steps to make the benefit less confusing.
Make prescription drug importation legal and safe
Americans often pay twice as much for prescription drugs as people in other countries. That is why Senator Dorgan introduced Pharmaceutical Market Access and Drug Safety Act. This legislation would allow consumers to safely import more affordable prescription drugs from Canada and several other countries.
