On Friday, Jan. 13, Forbes Magazine contributor, John Osborn, posted an article with this title: “‘Repealing and Replacing’ Obamacare: Whatever You Do, Preserve Medicare Part D and Fill the Donut Hole.” The same day the U.S. House of Representatives voted 227-198 to support a Senate budget resolution to eliminate six key provisions of the Affordable Care Act ( “ACA”/ “Obamacare”).
Many Seniors don’t realize that under Obamacare the “donut hole” of the Part D, Medicare Drug Plan will be effectively eliminated by 2020. Take Kristi, who, to control asthma, takes two puffs a day from a Dulera inhaler that costs around $300 for 120 doses, and one Spiriva capsule a day, at $1,000 for a 90 day supply.
By March each year, Kristi has fallen into the donut hole, meaning that, after exhausting her initial benefits, she had to pay out-of-pocket for drugs until reaching a threshold amount. Obamacare increased her drug benefits each year: from $2,850 in 2014 to $2,960 in 2015, to $3,310 in 2016 and to $3,700 for 2017. According to the January-February 2017 Issue of the AARP Bulletin, “…between 2010 and 2015 nearly 11 million Medicare beneficiaries saved $20.8 billion dollars on prescription drugs – an average of $1,945 per person – because of the gradual closing of the donut hole.”
Under Obamacare, the 2017 threshold level is $4,950. With Obamacare, if Kristi purchases a brand-name drug that retails for $100, she will pay $40, but $90 is credited toward meeting her threshold. If she buys a generic drug that retails for $100, she pays $51, which will count toward the threshold.
Seniors should join Kristi in telling their Congressmen and Senators that, instead of repealing Obamacare, retain it with improvements, particularly preserving elimination of the “donut hole” benefit. They should also contact these five Republican Senators who support slowing down the repeal procedure: Senator Bob Corker – (202) 224-3344; Senator Lisa Murkowski – (202) 224-6665; Senator Rob Portman – (202) 224-3353; Senator Susan Collins – (202) 224-2523; and Senator Bill Cassidy – (202) 224-5824. Let’s hope it isn’t too late.
Sandra W. Reed is an attorney with Katten & Benson, an Elder Law firm in Fort Worth, Texas. She lives and practices in beautiful Somervell County, near Chalk Mountain.