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Part D "Rebates" Go Against the Spirit of the Medicare Program

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As the debate around avoiding the fiscal cliff intensifies, older Americans are increasingly concerned about how any down-to-the-wire decisions could impact their health care. Especially concerning is that Congress might consider another round of cuts that could jeopardize the successful Medicare prescription drug benefit known as Part D.

A rare example of a federal government program that does exactly what it's supposed to, Part D provides access to affordable medicines for those who need them in an efficient and effective manner. It costs $400 billion dollars less than the government number-crunchers first predicted in 2006 and is producing real savings for seniors with average premiums at about $30 a month. In addition, the ACA mandated deep discounts on brand-name prescription drugs to save seniors even more by phasing out the donut hole in the next few years.

Seniors understand the need to address the growth in health care spending and are just as concerned with ensuring sustainable health care programs as the next generation. But what they will not stand for is a strategy to improve our fiscal dilemmas at their expense. This next round of cuts being floated by policymakers as a "rebate" for Part D drugs will do just that.

Framed as a cost saver, the proposed Medicare Part D rebates are actually nothing more than an added tax on seniors. Any savings would be paid directly to the government, not seniors or lower-income beneficiaries. This is nothing more than cost shifting back onto beneficiaries, while the government collects the new revenue to spend any way it wants. In fact, experts have estimated that a rebate could increase average monthly premiums for seniors by 20 to 40 percent. This is of particular concern for older Americans who often live on limited incomes and cannot afford an increase in their monthly expenses.

The Part D rebate could also lead to further unintended consequences such as reduced access to critical medications. Considering that many seniors depend on multiple drugs to manage their health, restricting the options available in each plan may reduce seniors' ability to adhere to the medications as prescribed by their doctor. According to a recent report from the non-partisan Congressional Budget Office, the use of medicines in Part D decreases spending for other medical services in Medicare, helping to keep seniors healthier and out of the hospital. Naturally, if a patient can't take the medication their doctor prescribes, it is easy to deduce what will happen to their health. Their condition will undoubtedly deteriorate and they will need a higher level of care in either a hospital or costly long-term care facility -- two places no American wants to end up.

While there are certainly many areas of Medicare and Medicaid that need to be improved, and should be, we must ensure patients aren't harmed in the process. As they grapple with a balanced strategy for addressing the deficit, members of Congress would be wise to think twice about altering one government program that is saving money and is widely popular among those it serves.