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Agreement Seen On Medicare Prescription Drug Benefit

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Agreement Seen On Medicare Prescription Drug Benefit



A bipartisan agreement to establish a Medicare prescription drug benefit was pending at press time.

A Senate Finance Committee representative told National Underwriter that it was possible an agreement would be announced late Thursday afternoon, June 5, and be the subject of a hearing scheduled for Friday, June 6.

However, the representative declined to provide any details.

Subsequently, Reuters Newswire reported that a tentative agreement had been reached among key senators but that it was not certain whether all the components had been worked out or whether all the details would be made public.

Earlier in the day, published reports said that under the plan being drafted by Finance Committee Chairman Charles Grassley, R-Iowa, and Ranking Democrat Max Baucus, D-Mont., health plans providing drug coverage would assume 2.5% of any losses during the first two years of the plan.

The government would then assume 75% of losses up to 5% and 90% beyond that.

The private sector exposure would increase in the third year of the plan by a still uncertain amount.

Mohit Ghose, a representative of the Washington-based American Association of Health Plans, says that private health plans believe they can provide a prescription drug benefit just as they do in the Medicare+Choice program if funding is available.

Ghose notes that two-thirds of Medicare beneficiaries who select the Medicare+Choice option have a prescription drug benefit.

He adds, however, that drug coverage under the Medicare+Choice program has been decreasing due to a lack of funding from Congress and the administration.

Ghose says that at press time, AAHP also has not seen details of the possible agreement.

For an update on the pending proposal, see National Underwriters Web site at

Reproduced from National Underwriter Edition, June 9, 2003. Copyright 2003 by The National Underwriter Company in the serial publication. All rights reserved. Copyright in this article as an independent work may be held by the author.


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