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Friday Folly: Blunt Defends Medicare Donut Hole

Roy Blunt criticized the changes to Medicare Part D coverage in the health care reform law on KFRU this morning, saying that reforms to close the gap in prescription drug coverage are "actually...going to make that system work not as well."  In Blunt's mind, the virtue of the current coverage gap for prescription drug costs is that desperate seniors might be more inclined to chose generic drugs. Listen to Blunt's response to a question from KFRU host Simon Rose:

Encouraging the use of generic drugs of name-brand drugs is great, but Blunt is back in health care crazy land on this one. (For refreshers on his previous forays into this territory, see here and here).  The health care reform law closes the donut hole entirely by 2020, and seniors are already receiving rebate checks if they fall into the coverage gap.  Starting next year, "the health care reform law says seniors will get a 50 percent discount on any drugs that would have landed in the donut hole in years past."

These are all bad things, Roy Blunt says.

Here's how AARP praised the Medicare Part D changes that Blunt says are bad news:

AARP officials applaud House passage of healthcare reform legislation, saying it ends the Medicare drug benefit "doughnut hole."

"We applaud the House for passing this critical legislation to make our healthcare system work for more Americans," A. Barry Rand, the chief executive officer of the AARP, said in a statement. "Both chambers have now passed a bill that will make healthcare more affordable for American families, strictly limit insurance companies from denying affordable coverage because of age or medical history, and protect and strengthen the benefits promised to people in Medicare. But the job is not finished."

The legislation closes the gap in Medicare drug coverage known as the doughnut hole, Rand said.

"For too long, seniors in Medicare have struggled with the rising cost of prescription drugs," he said.

As part of Medicare Part D, the first $295 of medications is paid by the beneficiary and for the next $2,700, beneficiaries pay 25 percent and Medicare pays 75 percent.

For 2010, the doughnut hole for the total true out-of-pocket expenses increased to $4,550 before catastrophic coverage begins. Once drug costs reach $4,350.25, Medicare pays 95 percent of the cost and the beneficiary pays 5 percent.

"For too long, seniors in Medicare have struggled with the rising cost of prescription drugs," Rand said.

"We look forward to working with the Senate in the coming days to finish this truly historic task," he said.

And Roy Blunt says these changes are "actually...going to make that system work not as well."  Who is he looking out for here?

Blunt may be more defensive than normal when it comes to discussing Medicare Part D policy.  He led the House Republicans' arm-twisting effort to pass Medicare Part D legislation in 2005.  And beyond the ugly tactics used to get the bill passed, it was a remarkably irresponsible bill.  Bruce Bartlett, a former policy advisor to Ronald Reagan and George H.W. Bush, explains:

Just to be clear, the Medicare drug benefit [passed in 2003] was a pure giveaway with a gross cost greater than either the House or Senate health reform bills how being considered. Together the new bills would cost roughly $900 billion over the next 10 years, while Medicare Part D will cost $1 trillion.

Moreover, there is a critical distinction--the drug benefit had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit, whereas the health reform measures now being debated will be paid for with a combination of spending cuts and tax increases, adding nothing to the deficit over the next 10 years, according to the Congressional Budget Office...

It astonishes me that a party enacting anything like the drug benefit would have the chutzpah to view itself as fiscally responsible in any sense of the term. As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt. Space prohibits listing all their names, but the final Senate vote can be found here and the House vote here.

To Blunt's credit, he is fairly honest about the fiscal irresponsibility of the prescription benefit.  He has even cited his party's failure to fund the program as a key reason why we shouldn't pass any sort of health care reform in 2009/2010. Speaking with KY3's Dave Catanese about the program last August:

BLUNT: I'm certainly of the belief that the government should first do what it said it was gonna do before taking on a new obligation.

CATANESE: You mean the prescription drug benefit?

BLUNT: Well, you know, that was a very costly addition to Medicare. Now the way we did it it turned about to be 40% cheaper than anybody estimated because we created a competitive marketplace. But that was, that's a big item.

CATANSE: But it wasn't paid for.

BLUNT: It was not. It was not. [chuckle] It was a $400 billion addition to Medicare.

Watch Blunt laugh about his hypocritical deficit spending here.



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