WASHINGTON, D.C. -- Today U.S. Rep. Edward J. Markey (D-MA), a senior member of the House Energy and Commerce Committee, unveiled the startling rates of Massachusetts residents who have significant gaps in their Medicare coverage.  The report, prepared by the House Ways and Means Committee looked at 140,175 seniors and disabled workers in Massachusetts, and concluded that 90% of newly enrolled Medicare Part D beneficiaries are at risk of falling into the “doughnut-hole,” the part of the program that contains a gap in coverage where beneficiaries continue to pay premiums without receiving financial coverage for medicines.  The report also concluded that only 6,706 new enrollees gained  full, uninterrupted coverage through the new law and that those beneficiaries paid a high price – premiums that were 253% higher – to get full coverage.

Rep. Markey said, “The confusing Medicare Part D program continues to give too much money away to drug companies without providing seniors a strong enough benefit package. This unacceptable gap in coverage for workers throughout Massachusetts is precisely why I urged my colleagues to reject the program in 2003. But along with repeated budget cuts to Medicare, Part D has left the health and well being of nearly all Massachusetts enrollees with spotty coverage at best.”

The Massachusetts “Doughnut-Hole” Report reveals that:
-         An alarming 90% of Medicare of Medicare Prescription Drug plan enrollees* in Massachusetts are enrolled in prescription drug plans that contain a doughnut-hole, or gap in coverage;
-         Only 4.3% of Massachusetts’s new Medicare Prescription Drug plan enrollees* are in plans with full, uninterrupted coverage;
-         Of the 44 plans available in Massachusetts, 84%—or 37 plans—have a gap in coverage;
-         Massachusetts residents enrolled in full coverage plans, without a gap in coverage, have to pay 2.5 times more in premiums than those in plans that have a gap;
-         The average annual premium for a full coverage plan $660.96

Rep. Markey continued, “Just when seniors and people with disabilities thought their battle with the Medicare Prescription Drug program was over, they are now beginning to realize that the program is littered with gaping holes.”

Democrats have offered an alternative plan to fix the new Prescription Drug program. In the Democratic Prescription for Change, House Democrats have proposed making the Medicare drug benefit simple, affordable, and reliable for senior citizens and people with disabilities.  Under the proposal, Medicare would be required to use its bargaining power to negotiate lower drug prices, and the savings would be used to fill the doughnut hole.  The Democratic plan would also waive the late enrollment penalty for millions of beneficiaries who are now locked out of coverage until 2007, and simplify the program by creating a Medicare-sponsored option.

You will find a copy of the House Ways and Means Committee Doughnut-Hole Report here:06 09 21 Doughnut Hole Report.pdf

*Percentages are of Medicare beneficiaries that are not eligible for low-income subsidies through Medicare or Medicaid when they enter the gap in coverage

September 22, 2006

CONTACT: Israel Klein