• A path to a disproportionately generous drug benefit?

    Does the House GOP’s Path to Prosperity, now endorsed by the chamber’s passage of the Budget Resolution in a strict party-line vote, retain Medicare Part D in its current form? If it does, something strange would happen.

    Part D premium subsidies are set at about 75% of the national average premium. That is, they will keep pace with drug costs.

    However, the Path to Prosperity plan for Medicare Part’s A, B, and C is to eliminate them in their current form and replace them with subsidies for private coverage that are indexed to inflation. They will not keep pace with health care costs which grow much faster than inflation. The CBO has predicted that beneficiaries’ out of pocket costs will grow two to three fold higher by mid-century under the Path to Prosperity approach than under current law.

    But that won’t happen for prescription drugs if Part D is retained. Since Part D was (incorrectly) held up as a motivating example of what the Path to Prosperity would bring to all of Medicare, it would be more than ironic if the House GOP intends to scrap it. I don’t think that is the intention. (Am I wrong?)

    Would Medicare beneficiaries end up with disproportionately generous drug benefits, well out of line with what they could afford for non-drug health care? It would seem so. That doesn’t necessarily make a lot of sense in terms of health. Drugs are great, but not everything can be solved that way.

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    • Look at it this way, a beneficiary of Part D is the pharmaceutical industry. It’s a very powerful industry. Disproportionate benefits are going to it. That Medicare participants also get benefits is a necessary side effect.

    • Ryan voted for Medicare Part D, so perhaps he feels obligated to maintain it?

      Steve

    • Although I can’t find any specific language about Part D in Ryan’s Path to Prosperity, it seems clear from the numbers that Part D wouldbe subsumed within the proposed voucher. That was certainly the case in Ryan’s Roadmap (H.R. 4529, 111th Congress).