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Nelson: Closing Medicare ‘donut hole’ a ‘win-win’ for seniors and taxpayers

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U.S. Sen. Bill Nelson (D-FL) today urged Senate leaders to close the gap in Medicare’s prescription drug coverage, commonly known as the “donut hole” by 2019, as a way to not only lower the cost of prescription drugs for seniors, but also to help pay for additional disaster assistance needed in places like Florida and Puerto Rico.

Nelson says closing the so-called Medicare “donut hole” early would save taxpayers approximately $9 billion over ten years and help offset some of the additional spending being proposed in a budget deal the Senate is expected to take up later this week.

“Closing this gap in coverage will save seniors thousands of dollars every year on the cost of their prescription drugs,” Nelson said. “It also saves taxpayers more than $9 billion over ten years. To me, that’s a win-win for everyone.”

Under the nation’s current health care law, the Medicare “donut hole” is expected to close by 2020. Nelson says closing this gap in coverage by 2019, instead of 2020, and shifting more of the cost to drug makers, instead of Medicare, will help provide additional savings for both seniors and taxpayers.

According to the Department of Health and Human Services, previous provisions to close the “donut hole” have 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.

HHS nominee dodges questions on closing Medicare donut hole

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U.S. Rep. Tom Price, the president’s nominee to head the Department of Health and Human Services, refused to say during a confirmation hearing today whether he supports certain key provisions of the Affordable Care Act that are saving Florida’s seniors, on average, nearly $1,000 per year on the cost of their prescription drugs.
“I’m humble enough to believe that there are better ideas out there,” Price said in response to a question by U.S. Sen. Bill Nelson (D-FL), who earlier this month filed legislation that would have prevented the Senate from repealing the provisions aimed at closing the gap in Medicare’s prescription drug coverage, commonly known as the “donut hole.”
“Congressman,” Nelson responded, “as their senator and as the protector of senior citizens in Florida, I can’t get away with an answer like that. I’ve got to tell them that I am going to support your right to get drugs under Medicare Part D just like you’re getting it now and not take it away from you.”
Below is a rush transcript and here’s a link to watch video of the exchange: https://youtu.be/L2aWyI1XZ10.
U.S. Sen. Bill Nelson
Senate Finance Committee Hearing
Jan. 24, 2017 
Nelson: I mentioned earlier, and I did so yesterday, that senior citizens – we have 4 million in Florida on Medicare – but there are almost 2 million people in Florida that now get their health care through the ACA and on Medicare Part D, the drugs, what we have tried to do, is close the amount of money that seniors have to pull out of their own pocket, otherwise known as the “donut hole.” You want to comment, Congressman, about whether or not seniors should have retained that federal ability to purchase their drugs?
Price: Well, in view of the fact that two of those senior citizens in your state are my mother-in-law and my father-in-law, I need to tread very carefully here. It’s – the concern that I have about, one of the concerns I have about drugs for being available for seniors is the accessibility of the drugs that they need and desire. And so we need to make sure that formularies aren’t limited, that we aren’t decreasing the access and availability of medications that seniors have available to them for the care that they receive.
Nelson: And so, the part of the ACA that closed that donut hole for senior citizens, you would support that part?
Price: As I say, I think it’s imperative that we provide the greatest amount of opportunity for individual seniors to be able to gain access to the drugs that they need. So often times in these discussions we think whatever we’re doing right now is the only solution that’s possible and I just – again I’m humble enough to believe that there are better ideas out there and if we find a better idea that actually provides greater coverage at a lower cost, more efficiently and more responsive to patients, then we ought to say – we ought to be able to admit that we would embrace that if it were to come along.
Nelson: Congressman, as their senator and as their protector of senior citizens in Florida, I can’t get away with an answer like that. I’ve got to tell them that I am going to support your right to get drugs under Medicare Part D just like you’re getting it now and not take it away from you.
Price: And, I understand that. And I would respectfully suggest that if we used as a society the line, we’re going to maintain the kind of quality coverage that we have right now unless we’re able to improve it and then we just might be able to do that for you.
Nelson: And if I gave them that answer I’d get run out of the room with a group of senior citizens. Thank you, Mr. Chairman.

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

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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.