81% OF MEDICARE PRESCRIPTION DRUG PLAN ENROLLEES IN PENNSYLVANIA ARE AT RISK OF FALLING INTO THE DOUGHNUT-HOLE*

May 8, 2006
Press Release

Washington, DC – U.S. Representative Mike Doyle (PA-14) announced today that 169,440 seniors and disabled workers in Pennsylvania -- 81% of newly enrolled Medicare Part D beneficiaries -- are at risk of falling into the “doughnut-hole,” the part of the program that contains a gap in coverage where beneficiaries continue to pay premiums without receiving financial coverage for medicines. Nationwide, 88% of Medicare Part D enrollees are at risk. The report also concluded that only 13,122 Medicare Part D enrollees in Pennsylvania gained full, uninterrupted coverage through the new law and that those beneficiaries paid a high price – premiums that were 131% higher – for full coverage.

“I’ve said all along that the Medicare prescription drug program proposed by President Bush and enacted by his supporters in Congress didn’t do enough to help our nation’s seniors,” Congressman Doyle said today in releasing this report.“Unfortunately, my prediction is now coming true. In the coming months, millions of our senior citizens will have to pay thousands of dollars out of pocket for their medicines.”


  • An alarming 81 percent – 169,440– of Medicare Prescription Drug plan enrollees* in Pennsylvania are enrolled in prescription drug plans that contain a doughnut-hole, or gap in coverage;
     
  • Only 6.3 percent of Pennsylvania’s Medicare Prescription Drug plan enrollees* – 13,122 – are enrolled in plans with full, uninterrupted coverage;
     
  • Of the 52 plans available in Pennsylvania, 51 plans – have a gap in coverage;
     
  • Pennsylvanians enrolled in full coverage plans, without a gap in coverage, have to pay more than twice as much in premiums than those in plans that have a gap;
     
  • The average annual premium for a full coverage plan is $701.52.
     

 

“Pennsylvania’s senior citizens deserve better than this,” Congressman Doyle said. “That’s why I have been working with my Democratic House colleagues to fix the Medicare prescription drug program.”

Congressman Doyle and other House Democrats have proposed A Prescription for Change to make the Medicare drug benefit simple, affordable, and reliable for senior citizens and people with disabilities. Under the proposal, Medicare would be required to use its bargaining power to negotiate lower drug prices, and the savings would be used to fill the doughnut hole. The Democratic plan would also waive the late enrollment penalty for millions of beneficiaries who are now locked out of coverage until 2007, and simplify the program by creating a Medicare-sponsored option to the private for-profit plans that are currently beneficiaries only choice. More information about this plan can be found athttps://www.housedemocrats.gov/news/librarydetail.cfm?library_content_id=797.

The figures cited in this release come from a Congressional Report released today by the House Ways and Means Committee. A copy of the House Ways and Means Committee Doughnut-Hole Report is attached.

*Percentages are of Medicare beneficiaries that are not eligible for low-income subsidies through Medicare or Medicaid when they enter the gap in coverage.

 

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