Congress Must Act to Keep Prescription Drug Costs From Rising

By Eileen Doherty, MS ~

A massive increase in the out-of-pocket prescription drug costs for Colorado older adults is looming in the months ahead unless Congress steps in to fix the “out-of-pocket cliff”. Many Medicare beneficiaries who have benefited from the Part D program have experienced a decrease in the cost of prescription drugs in the donut hole. The funding for this protection is about to expire if Congress does not act.

For many of Colorado’s older adults on fixed incomes, this “Out of Pocket Cliff,” as it’s being called, will be devastating to household budgets.

One of the benefits of the federal Affordable Care Act was to lower the amount Medicare beneficiaries pay out-of-pocket before qualifying for catastrophic coverage levels. Congress must act soon to preserve the current formula and prevent patients from facing an increase of $1,200 or more per year before being eligible for catastrophic coverage.

The impact of higher out-of-pocket costs often results in patients not taking medicines as prescribed. Patients taking the amount and frequency of medications as physicians prescribe is critical to patients’ recovery and quality of life. In contrast, not following these instructions can cause significant health setbacks or result in an expensive hospital stay. One study showed that “non-adherence” to medication results in upwards of $300 billion annually in unnecessary health care costs.

The negative effects of sending patients over the “Out of Pocket Cliff,” including the threats to decreased health and increased out-of-pocket spending on prescription drugs by Medicare beneficiaries must be shared with the Colorado Congressional delegation.

The increased costs to thousands of Colorado Medicare beneficiaries for prescription drugs in return for some potential cost savings to the Medicare Part D by transferring these costs back to older adults is neither fair nor equitable to those who live on a limited income.

Today, Part D is helping millions of Americans to stay healthy and take medications according to their health care providers instructions. We encourage policymakers to pass legislation to reverse the impending “cliff “and keep Medicare beneficiaries healthy.

We need the Colorado Congressional delegation’s continued support to fight this potential loss of prescription drug coverage for Medicare beneficiaries. Share your personal prescription drug story with the delegation today! If Congress does not act, older adults will face higher out-of-pocket costs for prescription drugs. For assistance or more information, call 303-333-3482.

Eileen Doherty

Eileen Doherty

Eileen Doherty, MS is the Executive Director of the Colorado Gerontological Society. Her areas of expertise include management and administration of nonprofit organizations, education and training on issues related to older adults, advocacy and policy development on senior issues, and clinical practice in working with seniors and families to manage their lives in the later years. She has been the Director of the Society since 1982. She teaches Nonprofit Management for Fort Hays State University.


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