“It is unconscionable for this Congress to adjourn without addressing the prescription drug medicine crisis facing so many of our senior and disabled citizens,” Democrats said in the letter.  “If the House can meet many of the legitimate needs of health care providers, it certainly also can address the needs of Medicare beneficiaries.  To adjourn giving billions to managed care plans, but failing to help all seniors with prescription drug costs would be shameful.” 

The prescription drug benefit the Democrats’ would add to the bill would allow all seniors to choose between a defined benefit, a Medicare+Choice option or keep their own existing employer provided coverage.  The defined benefit has no deductible and covers half the cost of medicines up to $2,000 (gradually rising to $5,000 by 2009)  Any Medicare beneficiary with out-of-pocket costs higher than $4,000 would be protected fully against further expenses.  The program would cost patients $25 a month for the first year, and would increase gradually as benefits increased.        

The Congressional Budget Office reports that this proposal would cover almost all seniors, in contrast to the bill which passed the House this summer, which left 7.8 million Medicare beneficiaries unprotected.

Democrats are also hoping to offer amendments to ensure the bill includes additional protections and improvements for Medicare beneficiaries, as well as amendments that will improve hospitals, nursing homes, and other traditional providers.  The bill as reported by the Health Subcommittee would still give roughly 40% of the funds to HMOs and other managed care plans, even though they only serve about 15% of Medicare beneficiaries.

“In addition to the prescription medicine amendment, various Members in the Democratic Caucus would like to offer amendments to provide more balance to the bill, by ensuring that it includes additional beneficiary protections and improvements and does more for hospitals, nursing homes, and other traditional providers.  The bill as reported by the Subcommittee would give a disproportionate amount of that relief to HMOs,” the Democrats’ letter said.

“While our members endorse provider relief, we also believe that more of the surpluses which allow such changes should go to traditional providerts and the seniors and the disabled Medicare is designed to serve,” the letter stated.

In addition to Reps. Stark and Rangel, the letter was signed by Rep. Robert T. Matsui (D-Calif.), Rep. William J. Coyne (D-Pa.), Rep. Sander M. Levin (D-Mich.), Rep. Benjamin L. Cardin (D-Md.), Rep. Jim McDermott (D-Wash.), Rep. Gerald D. Kleczka (D-Wisc.), Rep. John Lewis (D-Ga.), Rep. Richard E. Neal (D-Mass.), Rep. Michael R. McNulty (D-N.Y.), Rep. William J. Jefferson (D-La.), Rep. John S. Tanner (D-Tenn.), Rep. Xavier Becerra (D-Calif.), Rep. Karen L. Thurman (D-Fla.), and Rep. Lloyd Doggett (D-Texas).