By Mike Lillis - 09/28/10 06:24 PM EDT
A pair of top House Republicans went after the White House Tuesday over new rules that will lead to next year's extinction of some Medicare prescription drug plans.
Reps. Dave Camp (Mich.), senior Republican on the Ways and Means Committee, and Wally Herger (R-Calif.), the ranking member of the Ways and Means health subpanel, said the "paternalistic" new guidelines will confuse millions of seniors forced to change Part D plans in 2011.
"This 'government knows best' approach to healthcare is a frightening consequence of the decision to break the President's pledge that 'if you like the plan you have you can keep it,'" the lawmakers wrote Tuesday in a letter to Health and Human Services Secretary Kathleen Sebelius.
The critique is a direct response to a recent report, conducted by Washington-based Avalere Health, indicating that new administration rules will force a number of Part D plans to fold next year — including the 2nd and 9th most popular plans by enrollment.
Those "meaningful differences" rules — created as a part of the new health reform law — are designed to limit the number of similar plans a single Part D sponsor can offer in one region, so as not to confuse seniors with an overwhelming number of choices.
Insurers, under the rules, are allowed to offer only one standard plan and up to two enhanced plans in any one region, with the Centers for Medicare and Medicaid Services (CMS) specifying "meaningful" cost differences between the two categories. For sponsors offering two enhanced plans, the agency has also established a minimum of coverage differences to distinguish the products.
Avalere estimates that more than 3 million of the roughly 17 million seniors enrolled in Part D will be forced to switch plans as a result of the changes. Those affected will be moved automatically to different plans offered by the same sponsor.
Still, the automatic switch has done nothing to appease Camp and Herger. The lawmakers are asking CMS for "all documents and correspondence related to CMS' decision to eliminate prescription drug plans over the last two years."