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As we come upon the 10th anniversary of the Medicare Part D program, is it still living up to its promise? What can be done to improve it?

Contributors Respond

Mary R. Grealy

Mary R. Grealy

President

Read Mary R. Grealy's bio

Read Mary Grealy's bio

Anyone who has witnessed the success of the Medicare Part D prescription drug program during its first decade of existence would have to agree that the program has consistently exceeded expectations.  When it was first conceived, critics said insurers would be reluctant to participate.  Then, it was argued the program wouldn't be affordable.  And when an ample number of plans did participate in each state, critics insisted that seniors would be confused by having so many offerings from which to choose.

These worries turned out to be unfounded.  This month, the Medicare Today coalition that the Healthcare Leadership Council launched when Part D began released its annual nationwide survey of seniors regarding their experiences with the program.  Ninety percent are satisfied with their prescription drug coverage.  Additionally, 88 percent say their Part D plan is providing good value and nearly nine in 10 say their Part D coverage has met their expectations upon enrolling.

These exceedingly high approval ratings, while unusual for any government program, are really not that surprising.  With multiple plans competing on the basis of price and quality of coverage, monthly premiums have remained affordable.  The Centers for Medicare and Medicaid Services (CMS) has already announced that the average monthly premium for 2014 will be about $31, making it four consecutive years without a significant increase.

That's not to say there isn't room for improvement.  Some in Congress have suggested radical changes to the pricing structure of Part D, a move that is hardly necessary given the affordability for beneficiaries and the fact that taxpayer costs are 45 percent below Congressional Budget Office projections for the past decade.  Any changes should not undermine the very properties that have made this program popular and effective.

Rather, we should take note of the portion of our Medicare Today survey showing that just one in three seniors plans on shopping for Part D plan alternatives during the upcoming open enrollment period.  In most cases, this is because beneficiaries say they are happy with the coverage they currently have.  Our survey showed, though, that there could be greater awareness of the resources and tools available to help beneficiaries in evaluating their plan choices.  The importance of providing essential, user-friendly information to beneficiaries has not diminished.

In terms of whether Part D has lived up to its promise, though, one has to take the word of 90 percent of America's senior population.  Prescription medications are accessible and affordable.  Medicare Part D is clearly fulfilling its intended mission.

Tommy Thompson

Tommy Thompson

Former Secretary, Health and Human Services

Read Tommy Thompson's bio

Read Tommy Thompson's bio

When I was Secretary of Health and Human Services, I was tasked with a major challenge: Find a way to provide affordable prescription drug coverage for millions of seniors who rely on often-expensive prescription drugs to stay healthy. That was 10 years ago. Now, tens of millions of seniors rely on the Medicare’s prescription drug benefit, or Part D, to help them afford their daily medications.

I’d like to be able to say the team that worked to develop Part D knew it would turn into a successful, popular program, but its success was in no way guaranteed. To start with, no one had ever tried to make such a drastic change to Medicare before – not since the 1960s when the program was established. We didn’t know whether the insurance companies would actively participate or whether seniors would take to the program, but we knew something had to be done to provide affordable access to prescription medications for seniors across the country.  We also had the issue that even if we had the framework of a drug benefit program, there was limited probability that legislation of this magnitude would pass Congress.

There were a lot of critics of our plan and a lot of doubters. Even some of the people in Congress who supported the bill weren’t sure it was going to work. But I felt strongly that a competitive market-based solution could solve one of the major public health challenges we were facing by effectively and efficiently connecting seniors to the prescription drugs they needed. In that regard, we have been proven right.

Medicare Part D has achieved these goals and then some. Tens of millions of American seniors now have access to prescription medications they otherwise wouldn’t. Program costs for 2014 are projected to be more than 40 percent less than original estimates, and seniors’ premiums are roughly half of what they were expected to be. Part D’s affordability and ease are major reasons it is one of the most successful federal programs ever – 90 percent of seniors are satisfied with Part D!

While we should continually take stock of what is working with Part D and what could be improved, the overall framework has been a proven success.

Bobbie Ann Brinegar

Bobbie Ann Brinegar

Executive Director, Older Women's League

Read Bobbie Ann Brinegar's bio

Read Bobbie Ann Brinegar's bio

Since its inception in 2003, the Medicare prescription drug benefit, also known as Part D, has helped older individuals have affordable access to medications necessary to stay healthy as they age. Increasing access to affordable prescriptions drugs was a long-overdue reform to our nation’s health delivery system and an important step on the march toward ensuring every American has access to health care coverage. But while the program has done a lot of things well – at $31 per month, Part D premiums for 2014 are roughly half of what they were initially expected to be – but as with any federal program, there is still room for improvement.

For too long beneficiaries were at the mercy of the Part D’s “donut hole,” a gap in coverage that left seniors paying high out-of-pocket costs for prescription drugs. That donut hole has since been closed thanks to the Affordable Care Act. While there will surely be more tweaks as Congress learns from past results to perfect the program, one thing is not up for debate – seniors love Part D.

And according to the recent Health Leadership Council survey, 89 percent of women are satisfied with the program.

While Part D may not be perfect, it marks an important step forward in the history of America’s healthcare system. More patients have access to vitally-important prescription medications than ever before – and at reasonable prices. Going forward, expanding access to prescription drugs and other necessary medical treatments will continue to the effort to improve America’s health care system.