Key Dems break with White House on Medicare change

A number of powerful Senate Democrats broke with the Obama administration Friday by opposing proposed changes to Medicare's prescription drug program.

Led by newly installed Chairman Ron Wyden (D-Ore.), all but four Democrats on the Senate Finance Committee criticized a suggested overhaul that would enlarge the government's role in Part D.

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The letter, also signed by Finance Republicans, described the strength of the current program and urged Medicare officials to abandon their plans to change it.

"We are perplexed as to why [you] would propose to fundamentally restructure Part D by requiring immediate, large-scale changes to the program," the lawmakers wrote.

"Many of the proposed changes are untested and unstudied and could result in significant loss of beneficiary choice, access and consumer protections."

The criticism represents a major blow to the overhaul initiative, which had already been panned by Republicans as a negative for Part D.

The Centers for Medicare and Medicaid Services recently floated rules that would allow the agency to participate in negotiations between insurance companies and pharmacies in the program for the first time.

The regulations would also open plans' preferred networks to a wider range of pharmacies, limit plan bids within a region and remove "protected class" designations for certain types of drugs.

Though each involves its own fight, the proposals taken together have also triggered a serious backlash.

The Chamber of Commerce recently joined top insurers, drug companies, disease advocates and pharmacy chains to voice its opposition.

"The rule would significantly reduce beneficiaries' choice of plans and medicines and lead to disruptions in care. ... It would fundamentally transform the market-based competitive models that have made the Part D program highly successful," the groups wrote to regulators.

Federal health officials counter that a revised system would save money, hold plans and providers to account and enhance consumer choice within Part D.

The CMS hopes to finalize its proposal to take effect for the 2015 contract year, a very slim timetable for rule-making.

The four Finance Democrats who did not sign Friday's letter were: Charles Schumer (N.Y.), Maria Cantwell (Wash.), Ben Cardin (Md.) and Sherrod Brown (Ohio).