Democrats assail 'doughnut hole' in Medicare plan
WASHINGTON -- Filling the doughnut hole in Medicare drug plans would cost seniors and the disabled about $40 a month more.
Democratic lawmakers estimated the additional cost and said yesterday that it's a major reason why 88 percent of the Medicare beneficiaries signing up for drug plans opted for a coverage gap.
They designated today as ``doughnut hole day," when the coverage gap would hit the average senior taking several medications.
``This gap in coverage doesn't have to exist. This was a conscious choice, based on a value system, that put drug companies ahead of our seniors and people with disabilities," said Senator Debbie Stabenow, a Michigan Democrat.
The Bush administration estimates that about 3 million Medicare beneficiaries will hit the doughnut hole, fewer than the 7 million often cited by critics. Mark McClellan, the administration's point man on Medicare, says the 7 million figure is outdated.
Under the standard Medicare plan, the government subsidizes the drug costs for seniors and the disabled.
But after costs reach $2,250, the subsidy stops until a beneficiary has paid $3,600 of his or her own money. Then, the government will start picking up 95 percent of each purchase.
But beneficiaries go back to square one with each new year, and could face the doughnut hole repeatedly over the ensuing years.
And beneficiaries must pay the monthly premium even while they are in the doughnut hole.
Those qualifying for a low-income subsidy are not included in the Democrats' estimate of those facing hardship, nor are those who enrolled in Medicare Advantages programs, which work like an HMO.
McClellan, administrator of the Centers for Medicare and Medicaid Services, emphasized that beneficiaries who fall into the gap got a lot of government assistance beforehand.
``If you reach the doughnut hole, you've already gotten $1,500 or more worth of help with your drug costs," McClellan said.
According to the Democrats, it would cost $458 a year on average to switch to a plan that had full coverage. But that figure varies from state to state.
