Rep. Ryan Wants to Push Retirees Back into the “Donut Hole”

by Linda Bennett  |  May 27, 2011

An often overlooked benefit of Medicare is the access it provides to prescription drugs for millions of recipients, or Medicare Part D. However, due to Medicare Part D’s coverage gap—referred to as the “donut hole”—beneficiaries whose prescription costs exceed $2,800 annually are responsible for the FULL cost of their drugs until costs exceed $4,550, at which point coverage kicks back in. That all changed with the passage of health care reform last year.

An important provision in the Affordable Care Act requires drug companies to provide a 50% discount on covered name drugs for Medicare beneficiaries who are in the donut hole.

So far, more than a quarter of million people across the nation have used the discounts to save an average of $613, for a total of $166 million. This critical relief for seniors with high prescription drug costs is part of the early implementation of the Affordable Care Act.

Assistance for Medicare beneficiaries who have high prescription drug costs will continue to expand, and by the end of the decade the coverage gap in the Medicare prescription drug program will be gone.

Without the Affordable Care Act, many retirees would be forced to cover insurmountable prescription costs on their own. Apparently this is exactly what House Budget Committee Chairman Paul Ryan (R-WI) has in mind. His budget proposal, which passed the House of Representatives in April along party lines, reinstates the donut hole by repealing provisions of the Affordable Care Act. In January, the House of Representatives voted to repeal the Affordable Care Act, largely along party lines.