Agency Head Praises Donut Hole Relief

January 24, 2011 Updated: January 24, 2011

[xtypo_dropcap]A[/xtypo_dropcap]fter the theatrical floor debate on repealing the "Job-Killing Health Care Bill,” the federal government released a new statement enumerating benefits of the Affordable Care Act. Kathleen Sebelius, U.S. Department of Health and Human Services secretary, announced that 3 million Medicare beneficiaries have gotten help paying for medicine because of the new law.

“For too long, many seniors and people with disabilities have been forced to make impossible choices between paying for needed prescription medication and necessities like food and rent,” said Sebelius in a press release on Jan. 21. “The Affordable Care Act offers long overdue relief by lowering prescription drug costs each year until the donut hole is closed.”

People who were affected by the Medicare donut hole have been mailed a $250 rebate check to offset their costs for prescriptions. As more people enter the hole, more checks will be sent. The checks are part of the health care reform package signed into law in 2010.

The donut hole affects people whose prescription drug costs go over $2,800 per year. Below that amount, Medicare covers about 75 percent, once a deductible is met. For prescription expenses greater than $2,800, patients must pay 100 percent out of pocket. If an individual’s yearly drug costs exceed $4,500, Medicare coverage handles about 95 percent of the cost. A worst-case scenario of donut hole out of pocket expenses could reach $1,700.

The Department of Health and Human Services estimated the Affordable Care Act will save the average Medicare participant $3,500 over the next 10 years, it said in a statement. For those with disabilities or high prescription drug costs, the savings are likely to be greater, as much as $12,300 over 10 years, according to the agency.

Congress passed a resolution to repeal the bill on Jan. 19, but the resolution is not expected to actually repeal it. The Senate would have to also vote to repeal the Affordable Care Act, and President Obama would have to sign a new law to repeal the law he fought hard to persuade the House to pass.

When Obama accepted the nomination to run for president at the Democratic Convention in Denver in 2008, he told a story about his mother. She died of breast cancer in her fifties. He said he remembered her talking on the phone from her hospital bed as she lay dying. She was arguing with her insurance company over whether it would pay for her treatments.

Obama said he did not want to allow anyone else to go through that.