House Democrats Introduce Legislation That Would Allow Medicare To Offer Prescription Drug Plans That Compete With Private Plans

Congressional Democrats on Tuesday introduced legislation (HR 684, S 330) that would allow traditional Medicare to establish one or more plans to compete with private plans under the prescription drug benefit, CQ HealthBeat reports. In addition, the legislation, sponsored by Senate Majority Whip Richard Durbin (D-Ill.) and Reps. Marion Berry (D-Ark.) and Jan Schakowsky (D-Ill.), would strengthen the ability of Medicare beneficiaries to appeal denials of coverage for medically necessary medications under all Medicare Part D plans. The legislation also would require the HHS secretary to negotiate directly with pharmaceutical companies for the prices of medications under Part D.

Schakowsky said, "Under our bill, seniors and people with disabilities would finally be able to select a Medicare-operated drug plan that provides a guaranteed benefit without having to worry that their premiums will drastically increase or their access to needed drugs will drastically decrease each year." According to Berry, the plans established by Medicare would have the ability to obtain discounts on medications that private plans could not match. "If this works as we think it will, most of the private plans would drop out" of the Medicare prescription drug benefit, he said. Supporters of the bill include the American Public Health Association, the Center for Medicare Advocacy and the Medicare Rights Center.

In a statement, Pharmaceutical Research and Manufacturers of America Senior Vice President Ken Johnson said the group has begun to review the legislation and will work with sponsors to help Medicare beneficiaries obtain medically necessary medications. He added, "It's important to note, however, that the competitive market approach of the Medicare drug benefit is working well for patients and taxpayers" (Carey, CQ HealthBeat, 1/27).