As part of its incessant Massachusetts U.S. Senate campaign coverage in favor of Professor Elizabeth Warren of Cambridge by way of The Cherokee Nation and Harvard against Attorney Scott Brown of Wrentham by way of the North Shore and Suffolk, The Boston Globe reports October 4:
"Warren said a repeal of the (Patient Protection and) Affordable Care Act (PPACA) would effectively cancel hundreds of dollars in annual prescription drug assistance ready to be distributed to 11,000 seniors in the state..."
Perhaps the Globe reporter did not hear Professor Warren correctly but if she said the above she misunderstands how Medicare works and how PPACA works in relation to the already existing Medicare Part D prescription drug benefit. In particular, there is no "annual prescription drug assistance ready to be distributed" if Warren is referring to the relatively small PPACA-related brand-name drug discount seniors get if in the donut hole1.
Another possiblity -- my bet -- is that Warren is again purposely misinforming senior citizens about their Medicare prescription drug coverage benefits for political gain. And -- as an aside -- Warren also seems to be speaking against the position of the Democratic party, which has consistently opposed Medicare Part D.
Seniors, learn all about your Part D Medicare Presciption Drug benefits. Do not be fooled by Professor Warren.
-- Dennis Byron
1 I am assuming that Warren is referring in The Boston Globe quote to the fact that so far in 2012 according to HHS (through Aug 31), about 31,000 out of the approximately 1,100,000 people on Medicare in Massachusetts (3%) entered "the donut hole," which is the deductible portion of Part D Medicare drug coverage. It is not 11,000 as she says in the Globe article; 11,000 might have been the number back in the spring when Warren first started telling this lie.
These are all middle income or high income Massachusetts seniors; low income seniors are not subject to the donut hole and also get free premiums and nominal co-pays thanks to George W. Bush. Part D is a program passed in the President George W. Bush administration about 10 years ago, implemented in 2006, and opposed by Prof. Warren's party then and now (President Obama spoke against it on 60 Minutes a few weeks ago). Unlike most insurance, the deductible in Part D is in the middle of the coverage (and is therefore nicknamed "the donut hole") rather than at the beginning of the benefit coverage. I'm not saying that makes sense but that's the way they wrote the law, which is very popular, donut hole or not and despite Democratic Party opposition.
Because of Bush's and the Republican Party's support and against the Democratic Party's vote, these 31,000 seniors -- and another 200,000 to 300,000 of us seniors in Massachusetts that Warren conveniently seems to forget -- have saved about $1000 in prescription drug costs (at retail) so far in 2012 where we are in what is known as the initial phase of Part D. That's a total of $250 million that has nothing to do with PPACA or the donut hole. That's $250,000,000 we Massachusetts seniors would have spent if it were up to Professor Warren's party. Many of the 200,000 to 300,000 of us in the initial phase (those of us that have prescriptions but don't reach the donut hole) will save as much as $2000 each by the end of 2012 unrelated to PPACA. Again that's totally thanks to President Bush and despite the opposition of Professor Warren's party.
However, because of a secret 2009 deal made by the Obama White House staff with the pharmaceutical manufacturers relative to non-seniors (and well documented by the New York Times), later written into PPACA in 2010, the donut-hole Massachusetts seniors Warren mentioned also received a 50% discount on brand-name drugs this year. They received it at the pharmacy when they bought their drugs once in the donut hole. There is no "annual prescription drug assistance ready to be distributed," assuming Warren is referring to the PPACA discount in the donut hole. (I can't be sure because who knows what she means by "11,000 seniors;" there is no relevant number that I am aware of.). The money "saved" by the senior is between the drug companies and the pharmacists (which is true of all of these numbers which is why I keep saying "at retail") and is not distributed in any sense that one would use the word "distributed."
So if that's what Warren's talking about that's another $19 million from PPACA on top of the $250 million George Bush saved us. Although it's only for a few percent of us Massachusetts seniors and the Democratic-Party dollars represent only a couple of percent of the total savings from the Republican Part D program, none of us seniors is going to turn down found money. But at least Professor Warren should understand how it works. My guess is she does and just wants to keep on deceiving Massachusetts' senior citizens.
But more telling to the Massachusetts Senatorial race, there are two more things Warren does not seem to understand:
- Probably because she is not on Medicare yet and never really will depend on it because of her Harvard tenure, the real issue for us middle income Massachusetts seniors (remember low income seniors basically get all their drugs for a nominal co-pay with no Part D premium) is not so much whether you save $500 (most of us), $2000 (10% of us) or $3500 (3%-5% of us) but it's the concern we might be liable for tens of thousands of dollars in out of pocket (OOP) drug costs related to a catastrophic illness. This hits well under 1% of us but of course no one knows which few of us it might be. So the national Republican Part D plan covers 95% of all drug costs once a senior passes through the donut hole (meaning the senior would have first spent about $3500 for $12,000-$16,000 worth of drugs, whereas under the Democratic Party vote, the senior would have spent $12,000-$16,000).
- But -- and because she is not a Massachusetts native, Prof Warren might not know this -- Massachusetts has a special pharmaceutical assistance plan called Prescription Advantage for middle income seniors that does even better than Part D itself in terms of controlling OOP drug costs. As the chart above illustrates, individuals with incomes up to $55,000 and couples making up to about $70,000 in Massachusetts (and that's income even though many middle income seniors plan their retirement to use savings not income to live on) cannot spend more than around $3250 out of pocket. This OOP cap is even lower for lower middle income seniors (and as I said low income seniors are totally exempt from the donut hole and get drug insurance for free and have low co-pays). The HHS statistical model that projects 31,000 Massachusetts seniors saving $610 on the average in the donut hole so far in 2012 does not seem to take Prescription Advantage into account so the amount saved due to PPACA in Massachusetts is even less than the "hundreds" mentioned by Prof Warren or misunderstood by the Globe reporter.
This proves how frustrating this political campaign is. Warren, if quoted correctly by The Globe, can whip off a 10-word lie but it takes 500 words to explain her deceit.