Medicare Part D: Deserving of greater respect from policymakers

Despite its undeniable success on both health and financial grounds, the Medicare Part D prescription drug program continues to be the Rodney Dangerfield of federal programs.  Like the late comic, Part D can't seem to gain any respect in Washington, D.C.

Where the prescription drug benefit is concerned, there is a glaring appreciation gap that begins at the Capital Beltway.  Throughout the country, Medicare Part D has a 90 percent approval rate among senior citizens, according to a survey conducted last fall.  That popularity has been the case throughout the life of the program, as seniors continue to signal their support for a program that has made medications accessible and affordable.  Inside the beltway, though, policymakers continue to cobble together 'solutions' for non-existent problems with the program.

The latest example comes in the form of proposed regulations from the Centers for Medicare and Medicaid Services (CMS).  These proposed rules would strike at the heart of the structure that has made Part D a success -- providing beneficiaries with a choice of private plans and access to the drugs they need.   CMS has proposed limiting the number of Part D plans that can be offered in individual regions, would weaken the guarantee that classes of medications are fully available to patients with serious illnesses, and would limit the ability of plans to negotiate with pharmacies to reduce costs.

These changes don't constitute a tinkering around the edges of the program, but rather are drastic alterations that would create a new, far less effective Part D program.   What makes this proposal a real head-scratcher is the lack of a compelling rationale for radically revamping a proven success story.

CMS has itself praised the affordability of the Part D program, announcing last year that average monthly premiums in 2014 would stay at the same, stable level for the third consecutive year.  In every state, seniors and Medicare beneficiaries with disabilities can choose from multiple plans to meet their financial and medication needs.  And this competition has also generated savings for taxpayers and improved financial stability for the Medicare program, with Part D costs coming in more than 40 percent below original Congressional Budget Office projections.

This, of course, isn't the first time that a federal agency has proposed controversial regulations.  This effort stands out, though, because it is an inexplicable attempt to reshape a program that enjoys abundant popularity and that is clearly fulfilling its intended mission.  That explains why more than 250 organizations -- representing seniors, patients, multiple healthcare sectors, employers and Americans with disabilities -- have signed a letter to CMS, not suggesting changes to the proposed rules but rather urging that they be withdrawn altogether.

This insistence that proposed regulations be completely withdrawn is somewhat unorthodox.  It's the only approach that makes sense, however, to protect Part D beneficiaries from facing higher costs and fewer choices in both plans and medications.  There are certainly ways to make the Medicare prescription drug program even more effective, but undermining Part D's strengths isn't wise and it isn't acceptable.

Ironically, these proposed changes from CMS come as Medicare Part D celebrates its tenth year of making beneficiaries healthier and more financially secure.  After a decade of success, isn't it time that this program starts getting a little respect?

Grealy is president of the Healthcare Leadership Council, a coalition of chief executives of companies and organizations representing all sectors of American healthcare.

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