Representative Stark responds
to Bush’s Medicare rhetoric
WASHINGTON, DC -- U.S. Representative Pete Stark (D-CA, 13) released
the following statement today regarding the President's attempts to
raise support for his Medicare reform bill.
"The Medicare drug bill the Administration will begin implementing
next year is inadequate and overly complex. Unfortunately, the
President's rhetoric today will only confuse seniors and people with
disabilities further.
"The President's materials fail to mention the gap in drug coverage
for seniors, often called the donut hole. There is no mention that
while plans can periodically change the drugs they cover, seniors
are locked-into a plan for a full year. No mention of companies
ending coverage for retirees. And there is no mention that HMOs are
receiving huge taxpayer-funded subsidies. If his goal is truly
education, the President owes it to senior citizens and people with
disabilities to be upfront about the gaps in coverage and the
limitations of the program.
"While Republicans in Congress may fall for Bush's misleading
statements, it is clear the American people are not so gullible. As
with Social Security, the more they hear about the President's plan
for a privatized Medicare, the less they like it."
Stark's office released the following annotated commentary of White
House talking points on the new Medicare program:
Presidential staff claim:
Today, President Bush Delivered Remarks At The Department Of Health
And Human Services To Inform Medicare Beneficiaries About The New
Prescription Drug Benefit Available To Them Beginning In January
2006.
The President Is Kicking Off A National Outreach Effort. This
campaign will bring medical, community, and local partners together
with the Federal government to educate seniors and Americans with
disabilities about the new prescription drug benefit.
All beneficiaries will receive a new handbook, "Medicare and You," in
October, containing specific information about the new prescription
drug plans available. Those with questions can also call
1-800-MEDICARE or visit www.medicare.gov for answers.
Millions Of Americans Are Already Taking Part In Medicare's Expanded
Range Of Health Care Services. Medicare offers a variety of new
programs, including: a prescription drug discount card; preventive
care like the "Welcome to Medicare" physical; and cardiovascular and
blood sugar screening that can help identify and prevent obesity,
diabetes, high blood pressure, and heart disease.
Rep. Stark
annotation: Discount card terminates at the end of this year;
the new preventive benefits mentioned here are the ONLY new
preventive benefits (not illustrative examples as the text implies).
Presidential staff claim:
President Bush Wants Seniors And
Americans With Disabilities To Know About New Medicare Benefits New
Medicare Coverage Will Help All Medicare Beneficiaries Pay For
Prescription Drugs.
Everyone On Medicare Can Get Help, No Matter How They Pay For Their Drugs.
Medicare will provide an average of more than $1,300 in federal help
to each beneficiary.
Rep. Stark
annotation: $1300 represents the average benefit, but "each"
beneficiary will not receive that level of assistance. Ten percent
of beneficiaries have no drug spending at all. Many more have below
average spending.
Presidential staff claim:
Medicare Will Provide Extra Help To
Beneficiaries With High Prescription Costs. Starting in January,
Medicare also will cover 95 percent of all prescription costs once
beneficiaries spend $3,600 of their own money each year.
Rep. Stark annotation: Fewer than one in
five beneficiaries have spending that would qualify for this level
of assistance. More importantly, this description glosses over the
"doughnut" hole that precedes the catastrophic coverage, and it
excludes new Part D premiums (estimated to average $450/year). The
standard benefit under Part D is as follows: Total drug spending in
2006 (NOTE: All dollar amounts will increase in future years) $250
deductible Beneficiary pays 100% ($250) $251-$2250 Beneficiary pays
25% ($500) $2250 - $5100 “Doughnut” hole or gap; beneficiary pays
100% ($2850) >$5100 At this point, the beneficiary has paid $3600
(250+500+2850), plus premiums; beneficiary pays 5% or co-payments of
up to $5, whichever is greater Under the standard benefit, the
average person will run out of coverage in August of 2006, but still
be required to pay premiums for the rest of the year (because they
don't spend enough to trigger the catastrophic coverage).
Presidential staff claim:
New Medicare
Coverage Will Offer Everyone On Medicare Better Choices.
Medicare Advantage Plans Allow Seniors And Americans With
Disabilities To Choose Their Plans And Get Better Drug Benefits.
Seniors and Americans with disabilities who enroll in Medicare
Advantage Plans can choose the plan that works best for their needs
and lifestyle, and will save an average of $100 each month over
traditional Medicare.
Rep. Stark
annotation: The choices that matter most to beneficiaries are the
freedom to choose their doctors and hospitals, as is the case under
the traditional Medicare. This is a clear example of the
Administration's attempt to privatize Medicare by bribing
beneficiaries into HMOs and private plans. In addition, we have seen
no data to support their claim (though it is not necessarily
surprising, given the tens of billions of dollars in overpayments to
HMOs and private plans).
Presidential staff claim:
Medicare Drug
Benefits Offer Choice And Flexibility. Everyone on Medicare will be
able to choose brand name drugs or generic drugs – and pick them up
at local pharmacies or receive them by mail.
Rep. Stark
annotation: But the real question is whether you will continue
to have access to the specific drugs you take today. Covered drugs
will vary from plan to plan, and beneficiaries will likely have to
pay more to have access to a broader array of drugs. Plans have
"flexibility" to change which drugs are covered throughout the year,
but most beneficiaries are locked into their plan for the entire
year.
Presidential staff claim:
Seniors Can Keep Retiree Plans If They Wish. Seniors with good
retiree drug coverage from a former employer or union can choose to
keep those benefits and count on Medicare to help them save on
premiums, or join a Medicare prescription drug plan.
Rep. Stark annotation:
The employer is really the one with a choice to make, and the
Administration's actuaries and CBO both predict that many employers
will "choose" to drop coverage, meaning about 3 million
beneficiaries will lose their retiree coverage as a result of this
bill. Many more will see their coverage reduced even as employers
take advantage of the new subsidies.
Presidential staff claim:
New Medicare Coverage Will Provide
Extra Help To Beneficiaries With Limited Income And Resources.
Medicare Will Pay Nearly All Of Low-Income Beneficiaries' Drug
Bills. About one-third of seniors will be eligible for a Medicare
drug benefit without premiums, deductibles, or gaps in coverage.
Rep. Stark annotation:
Not true. This number includes 1.5 million beneficiaries with
incomes between 135-150% of the poverty level who will be subject to
a deductible and premiums. Co-payments will amount to no more than
$5 for most people, and more than 95 percent of their drug bills
will be covered. Staff comments: If you qualify for full premium
assistance, your "choice" is limited to plans with average or below
average premiums. Those plans will likely have more restrictive
formularies (fewer "preferred" drugs), and millions of low-income
people will be enrolled in plans that don't cover the drugs they
need. Approximately 6.5 million are the poorest, most vulnerable
beneficiaries who currently get comprehensive drug coverage through
Medicaid. These so-called "dual eligibles" will pay more and get
less under the new private plans. Adding insult to injury,
co-payments will increase each year.
Presidential staff claim:
Eligibility Forms Are Available Now.
Millions of current Medicaid beneficiaries will be automatically
enrolled, and subsidy applications have been mailed to many
low-income seniors and Americans with disabilities who are likely to
be eligible. Forms are also available at locations around the
country, including over 30,000 pharmacies. No financial documents or
complicated records are required.
Rep. Stark
annotation: Notwithstanding our concerns about the inadequacies and
other flaws of this law, people who are eligible for the low-income
subsidies should take advantage of the help. But they should choose
carefully, and care must be taken to help them understand that it is
a two-step process -- applying for the subsidy and choosing a plan.
Presidential
staff claim:
Medicare Is A
Critical Safety Net For Americans With Disabilities. Millions of
Americans with developmental and physical disabilities, mental
illness, and HIV/AIDS count on Medicare, and new Medicare coverage
brings modern medicine to them.
Rep. Stark
annotation: This law actually undermines the traditional Medicare
program, which preserves access to a broad array of specialists and
is the most important protection for beneficiaries with
developmental and physical disabilities, mental illness, HIV/AIDS
and other chronic conditions.
