Nelson files legislation to prevent repeal of Medicare “donut hole” provisions

U.S. Sen. Bill Nelson filed legislation today to prevent Congress from repealing key provisions of the Affordable Care Act that have, on average, saved many of Florida’s Medicare-covered seniors nearly $1,000 per year on the cost of their prescription drugs.
The measure, which Nelson filed as an amendment to a broader budget bill currently under debate, would prevent the Senate from considering any legislation that repeals the Affordable Care Act’s provisions aimed at closing the gap in Medicare’s prescription drug coverage, commonly known as the “donut hole.”
Under current law, when a Medicare beneficiary and their plan spends $3,700 on prescription drugs in a single year, that beneficiary becomes responsible for a larger share of the cost of their prescription drugs until the beneficiary’s total out-of-pocket costs for the year reach $4,950, at which time Medicare will resume paying for the cost of the drugs.
Prior to the 2010 healthcare law taking effect, the gap in coverage started at $2,700 and ended at $6,100. The provisions included in the ACA have shrunk that gap and aims to completely close it by 2020.
Nelson’s measure would protect those provisions, ensuring that seniors continue to save on the cost of their prescription drugs even if Congress repeals the rest of the law.
“Closing this gap in coverage, known as the donut hole, has helped seniors in Florida save nearly $1,000 a year,” Nelson said. “Why would you want to get rid of that? We should be looking for ways to lower – not increase – the cost of prescription drugs, especially for our seniors.”
According to the Department of Health and Human Services, the provisions Nelson wants to keep in place saved Florida’s 355,000 Medicare-covered seniors more than $350 million in 2015 alone. That’s an average annual savings of $987 per senior.
The text of Nelson’s legislation is available here.