Fewer choices in the future?
Last year, 10 companies out of 266 accounted for 66% of the enrollment in Part D plans with United Healthcare and Humana dominating the marketplace.5 Companies with low numbers of enrollees may eventually lose the right to participate in the Part D program since they can’t spread the risk of medication usage across a large enough population. Also, it’s likely that about 75% of beneficiaries in a PDP will have higher premiums in 2007, although many by only a few dollars per month.5
Will the government begin direct negotiations?
Democrats want the federal government to negotiate directly with drug companies on the price of Part D medications—something the Republicans didn’t allow in the original legislation. Now that Democrats are in control of the House and Senate, this issue will likely be revisited. In addition, because more beneficiaries will have coverage for all of 2007—as opposed to just part of 2006—it’s likely that more of them will reach the “doughnut hole” during the year. If that happens, Congress is likely to hear more complaints about the inadequacy of the program’s handling of drug costs.
The MA program may also become a political hot button. In the legislation authorizing the Part D program, the Republican-led Congress significantly increased payments to MA programs in an effort to attract more enrollees.
A Commonwealth Fund study released in November 2006, confirmed this by showing that payments for each of 5.6 million enrollees in an MA plan in 2005 averaged $922 or 12.4% more than costs for beneficiaries in the traditional Medicare fee-for-service program for a total of $5.2 billion. The Commonwealth study authors noted that these extra payments undermine the original intent of the legislation which was to have an MA program provide a more efficient alternative to the traditional Medicare program.6 This is another part of the original bill that Democrats argued against, and may be another area they choose to address in the new legislative session. With the shift in control over the House and Senate, only time will tell how Medicare Part D will evolve in the months ahead.
What’s on the public’s mind?
A poll taken done by the Kaiser Family Foundation and Harvard School of Public Health soon after the November elections showed that majorities of Democrats (92%), independents (85%), and Republicans (74%) supported the government negotiating prices for prescription drugs under Medicare and a majority of all polled (79%) supported allowing the purchase of drugs from Canada. Also, more than half supported federal funding of stem cell research.
The top health priorities were expanding coverage for the uninsured (35%) and reducing health care costs (30%). While health care and the economy were the leading domestic priorities for those polled (about 15% each), they both trailed far behind the war in Iraq (46%).
SOURCE: The Public’s Health Care Agenda for the New Congress and Presidential Campaign [Kaiser Family Foundation Web site]. December 2006. Available at: www.kff.org/kaiserpolls/pomr120806pkg.cfm. Accessed on March 20, 2007.
Correspondence
Eric Henley, University of Illinois College of Medicine at Rockford, 1601 Parkview Avenue, Rockford, IL 61107. ehenley@uic.edu