Government Relations Action Alert

Support Changes in Medicare Prescription Drug Legislation

September 2, 2003

The Issue at Hand

This is an update from our July 11 Alert.
On June 26, the House and Senate passed Medicare prescription drug bills (S.1/H.R.1) that would make significant changes in Medicare’s program structure and benefits. With the two bills now in a difficult conference committee phase, the National Association of Social Workers (NASW) is seeking to make improvements in the final bill by supporting a number of policies to address the shortcomings. Please see our July 11 Alert at https://www.socialworkers.org/advocacy/alerts/071103_alert.asp

Each version has positive elements in potentially lowering the cost of outpatient prescriptions for millions of older and disabled Americans — especially those with low incomes and with very high drug expenses. However, both bills are inadequate as they contain major gaps in coverage. Additionally, the gaps could lead to unaffordable increases in cost sharing requirements and to loss of insurance coverage from former or current employers. Provisions in the House bill that offer incentives for beneficiaries to enroll in private plans, which would ultimately set in motion a Medicare financing death spiral pose a grave concern.

The bill is at a critical juncture.
House and Senate conferees left for their August recess with many unresolved substantive issues, such as how to structure the drug benefit through health insurance plans and how to subsidize low-income seniors. Many lawmakers and experts believe that the bill’s passage may be in serious jeopardy, because conference committee members remain far apart on several key issues. While Congress reconvenes this week, no date has been set for the next conference committee meeting.

Action Needed

Send an e-mail or fax to your Senators and Representatives immediately with the sample message that appears on NASW’s Congress Web at http://63.66.87.48/cweb4/index.cfm?orgcode=NASW (the letter can be downloaded and edited). For your Senators’ or Representatives’ fax numbers – call the Capitol Switchboard (202-225-3121).

Ask your Senators and Representatives to contact the conferees from their own parties to convey their support for your position. The conferees are:

Changes Sought in Final Bill
NASW is concerned about key provisions of S.1/H.R.1, which have the potential to greatly harm the program and its future beneficiaries. Following is an outline of the priority corrections for the final version, which we explained in more detail in the July 11 alert. https://www.socialworkers.org/advocacy/alerts/071103_alert.asp

Privatization must not undermine the basic fee for service program.
The House bill requires that the traditional fee for service Medicare program compete against private plans, based on price, beginning in 2010. Ultimately, this could result in the dismantling of Medicare as a universal entitlement.

Increases in premiums and deductibles must be affordable.
Both bills add burdensome new deductibles and co-payments to traditional Medicare and the new prescription drug benefit.

Benefits must not be means tested.
Medicare reform must not include means testing. Relying on income levels to determine access to Medicare benefits would severely undermine Medicare's universal nature and fairness.

Benefits must apply equally to Medicaid dual eligible persons.
The Senate bill does not offer the Medicare drug benefit to seniors who are eligible for Medicaid. The House bill would slowly phase in the benefit for Medicaid and Medicare dual eligible persons.

Prescription drug coverage must be adequate.
The gap in drug coverage in both bills must be reduced. Many beneficiaries cannot afford to pay 100 percent of their drug costs between the basic benefit cap ($2,001 in the House and $4,501 in the Senate) and the catastrophic drug stop loss ($4,900 in the House and $5,813 in the Senate).

A reliable federal fallback program is essential.
Both bills create access to drug benefits through private plans. In rural areas, where few health plans may wish to market the new private plans, the Senate bill creates a federal fallback plan to ensure benefits remain available. Under the House plan, availability will be up to the private sector.

Timing

The time to contact your legislators is now.
There is uncertainty about how long the conference committee negotiations will last. Many expect consideration to continue well into October, although this is speculative. NASW will be advocating for these policy outcomes throughout the conference, targeting members of Congress — particularly the conferees — for grassroots action. Once we see the conference agreement, NASW will develop a position on whether or not to support final passage.

TAKE ACTION NOW!

THANKS FOR YOUR ADVOCACY!

If you have questions or need additional materials, please contact Enzo Pastore, NASW senior government relations associate, at epastore@naswdc.org or 202.336.8336.

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