WASHINGTON – Last week, United States Congresswoman Jahana Hayes (CT-05) introduced H.R. 4669, the Maximizing Drug Coverage for Low-Income Seniors Act. This bill seeks to improve the Medicare enrollment process and lower skyrocketing out-of-pocket costs by ensuring beneficiaries are enrolled in the Part D plan which best meets their needs. This is done by establishing an “intelligent assignment” process for low-income beneficiaries, rather than the current random system. The bill is cosponsored by Congresswomen Haley Stevens (MI-11), Terri Sewell (AL-07), and Annie Kuster (NH-02)
Under the current system, seniors eligible for the Low-Income Subsidy program are randomly assigned to a Medicare Part D plan. While these subsidies can reduce or cover premiums, deductibles, and coinsurance, the arbitrary assignment process can lead to considerable differences in out-of-pocket costs. The Maximizing Drug Coverage for Low-Income Seniors Act instructs the Secretary of the Department of Health and Human Services (HHS) to design a system which intelligently assigns beneficiaries to a plan in their geographic area based on their individual prescription drug needs, by taking into consideration factors such as prior medication use, pharmacy preferences, and drug cost.
Rep. Hayes said: “For too many Americans, the rising cost of prescription drugs has resulted in serious concerns about the ability to afford life-saving medication, something particularly acute for older Americans with limited incomes. The Maximizing Drug Coverage for Low-Income Seniors Act would help relieve that burden by deliberately assigning enrollees to Medicare plans catered to their individual needs, in contrast to the current system of random assignment. I thank Representatives Stevens, Sewell, and Kuster for their important work in protecting the health of our older Americans.”
Rep. Stevens said: “The exorbitant cost of prescription drugs is forcing countless families in my district to make the impossible choice between taking care of their health and putting food on the table. We cannot tolerate a system that is causing three in ten adults to not take their medication as prescribed due to high costs. There is much innovation that can be done in our great Medicare program to ease the burden of the high cost of prescription drugs, which tends to fall hardest on older adults. This legislation takes a step in that direction, by ensuring beneficiaries’ Part D coverage is actually working for them to keep them healthy at the lowest possible cost.”
Rep. Sewell said: “In the richest nation in the world, every American should be able to afford the highest quality lifesaving medications and, yet, I have heard from too many Alabamians who struggle to afford their prescription drugs due to skyrocketing costs. The Maximizing Drug Coverage for Low-Income Seniors Act is smart and innovative legislation to ensure seniors are enrolled in the best Medicare Part D program for their individual needs, saving them money on out-of-pocket costs and improving access to their needed medication.”
Rep. Kuster said: “I continue to hear from Granite Staters who struggle to pay for their prescription drugs, often being forced to choose between necessities like groceries and the medications they need. This problem requires a multifaceted solution, and this legislation is a step in the right direction. The Maximizing Drug Coverage for Low-Income Seniors Act is a commonsense approach that will ensure our most vulnerable Americans are matched with the prescription drug plan that’s best for them, saving senior and taxpayer dollars.”
The Maximizing Drug Coverage for Low-Income Seniors Act has the potential to save seniors thousands of dollars on out-of-pocket costs for the prescription drugs they need to stay healthy, while also generating savings in overall Medicare spending. It is supported by the National Council on Aging and Justice in Aging.
Rep. Jahana Hayes has been a public school teacher in Connecticut for more than 15 years and was recognized in 2016 as the National Teacher of the Year. Currently serving her first term in the U.S. House of Representatives, Rep. Hayes sits on the Committees on Education & Labor and Agriculture and proudly represents Connecticut’s 5th District.