A Flawed Solution for a Non-Existent Problem

February 19, 2014
12:21 pm

In a town that thrives on disagreement, there is a stunning degree of unanimity around the idea that the Center for Medicare and Medicaid Services (CMS) is moving in the wrong direction with its proposed regulations that would bring about sweeping changes to the Medicare Part D prescription drug program.

Over 230 organizations – representing patients, seniors, multiple healthcare sectors, employers and Americans with disabilities — have signed a letter that was delivered to CMS, urging the agency to withdraw the proposed rules.  The letter states that the regulations “will severely impede beneficiaries’ access to affordable health plans and medications and threaten “to disrupt the positive effect the (Part D) program is having on beneficiaries’ health and the Medicare program as a whole.”

In thinking about these proposed rules, the first question that comes to mind is……why?  The Medicare Part D program, as it stands, is an irrefutable success story.  It has the approval of 90 percent of seniors.  Average monthly premiums have remained at steady, affordable levels.  And the cost to taxpayers over the past decade has been more than 40 percent below original Congressional Budget Office projections.

So why attempt to “fix” what isn’t at all broken?

These rules aren’t a case of tinkering at the margins of the Part D program.  We’re talking about fundamental changes in how the system operates.  The rules would place new restrictions on the Part D plan options available to seniors.  There would be changes in the range of medications that could be available in certain pharmaceutical classes.  And Congress’s clear intent that pharmaceutical pricing be determined by private sector negotiations – with the federal government keeping hands off – would be blatantly disregarded.  Part D’s success in delivering affordability and healthcare quality would be placed at risk.

This is not to say that CMS, healthcare sectors and patients shouldn’t work together to continually improve the Medicare prescription drug program, but any changes should build upon the fundamental principles of consumer choice and competition that have made the program successful and improved the health and well-being of millions of beneficiaries.  These proposed regulations don’t meet that criteria and, in fact, would undermine those core strengths.