query: who signed into law the expansion of the medicare prescription benefit

pos: Medicare Prescription Drug, Improvement, and Modernization Act Drug Act expressly prohibited Medicare from negotiating bulk prescription drug prices. The "donut hole" provision of the Patient Protection and Affordable Care Act was an attempt to correct the issue. Medicare Prescription Drug, Improvement, and Modernization Act The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. The

pos: Medicare Prescription Drug, Improvement, and Modernization Act Medicare Prescription Drug, Improvement, and Modernization Act The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. The MMA's most touted feature is the introduction of an entitlement benefit for prescription drugs, through tax breaks and subsidies. In the years since Medicare's creation in 1965, the role of

pos: Medicare (United States) was established as a federal agency responsible for the administration of Medicare and Medicaid. This would be renamed to Centers for Medicare and Medicaid Services (CMS) in 2001. By 1983, the diagnosis-related group (DRG) replaced pay for service reimbursements to hospitals for Medicare patients. President Bill Clinton attempted an overhaul of Medicare through his health care reform plan in 1993–1994 but was unable to get the legislation passed by Congress. In 2003 Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which President George W. Bush signed into law on December 8, 2003. Part of this legislation included filling

pos: Budget sequestration delays in making obligations and payments, emergency designations, and specific directives. While staying within the technical definition of the law, this allowed spending that otherwise would not be allowed. The result was emergency spending of $34 billion in 1999 and $44 billion in 2000. The PAYGO statute expired at the end of 2002. After this, Congress enacted President George W. Bush's proposed 2003 tax cuts (enacted as the Jobs and Growth Tax Relief Reconciliation Act of 2003), and the Medicare Prescription Drug, Improvement, and Modernization Act. The White House acknowledged that the new Medicare prescription drug benefit plan would not

pos: Health savings account it, but people who have health problems that have predictable annual costs will avoid HSAs to have the costs paid by insurance. There is also debate about consumer satisfaction with these plans. HSAs were established as part of the Medicare Prescription Drug, Improvement, and Modernization Act, which included the enactment of Internal Revenue Code section 223, signed into law by President George W. Bush on December 8, 2003. They were developed to replace the medical savings account system. A survey of employers published by the Kaiser Family Foundation in September 2008 found that 8% of covered workers were enrolled in

pos: Ezekiel Emanuel rationed not by "death panels" but by The Medicare Prescription Drug, Improvement and Modernization Act of 2003, signed by President George W. Bush. The act limits Medicare payments for generic cancer drugs, which cuts profits from producing them and results in shortages. Emanuel's previous statements on rationing were about the "allocation of very scarce medical interventions such as organs and vaccines" such as who should get a "liver for transplantation". Ezekiel said that McCaughey's euthanasia claims were a "willful distortion of my record". Jim Rutennberg said that Emanuel's critics oversimplified complex issues, such as who should get a kidney. Such

neg: Medicare Prescription Drug Price Negotiation Act of 2007 Medicare Prescription Drug Price Negotiation Act of 2007 In January 2007, the 110th United States House of Representatives approved , the Medicare Prescription Drug Price Negotiation Act, a bill to require federal officials to negotiate with drug companies for lower prices for the 23 million senior citizens who have signed up for Medicare's prescription drug coverage. If passed, the law would repeal a ban on letting the government negotiate with manufacturers for lower prices — a provision that was part of the GOP-sponsored 2003 measure called the Medicare Prescription Drug, Improvement, and Modernization Act, which created the prescription drug program.

neg: National Breast Cancer Coalition Early Detection Program. The Act provides federal funding to help cover more than half of the cost to States that opt to cover treatment for these women through Medicaid. Since this legislation was enacted, all 50 States and the District of Columbia have opted into this program. This is a testament to the continued hard work of NBCC grassroots advocates at the State level. In December 2003, the Medicare Modernization Act was signed into law creating a prescription drug benefit for all Medicare beneficiaries effective in 2006. A provision providing transitional coverage for certain cancer drugs, from September 2004 until

neg: Ben Cardin His legislation to increase the amount individuals can store in their 401k plans and IRAs was passed in 2001. His bill to expand Medicare to include preventive benefits such as colorectal, prostate, mammogram, and osteoporosis screening was also enacted. He also authored legislation to provide a Medicare prescription drug benefit for chronic illnesses; fund graduate medical education; and guarantee coverage for emergency services. Cardin has also advocated, via proposed legislation, welfare reform. His bill to increase education and support services for foster children between ages 18 and 21 was signed into law in 1999. He authored bills to expand child

neg: George W. Bush Bush viewed the legislation as a move toward socialized health care, and asserted that the program could benefit families making as much as $83,000 per year who did not need the help. Following Republican efforts to pass the Medicare Act of 2003, Bush signed the bill, which included major changes to the Medicare program by providing beneficiaries with some assistance in paying for prescription drugs, while relying on private insurance for the delivery of benefits. The retired persons lobby group AARP worked with the Bush Administration on the program and gave their endorsement. Bush said the law, estimated to cost

neg: Medicare Part D prescription drug coverage under a Part D plan if they are signed up for benefits under Medicare Part A and/or Part B. Beneficiaries obtain the Part D drug benefit through two types of plans administered by private insurance companies: the beneficiaries can join a standalone Prescription Drug Plan (PDP) for drug coverage only or they can join a public Part C health plan that jointly covers all hospital and medical services covered by Medicare Part A and Part B at a minimum, and typically covers additional healthcare costs not covered by Medicare Parts A and B including prescription drugs (MA-PD).

neg: Medicare Part D Medicare Part D Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (the cost of almost all professionally administered prescriptions is covered under optional Part B of United States Medicare). Part D was originally proposed by President Clinton in 2000 and enacted as part of the Medicare Modernization Act of 2003 (which also made changes to the public Part C Medicare health plan program) and went into effect on January 1, 2006. Individuals on Medicare are eligible for

neg: Medicare Prescription Drug, Improvement, and Modernization Act prescription drugs in patient care has significantly increased. As new and expensive drugs have come into use, patients, particularly senior citizens at whom Medicare was targeted, have found prescriptions harder to afford. The MMA was designed to address this problem. The benefit is funded in a complex way, reflecting diverse priorities of lobbyists and constituencies. Beginning in 2006, a prescription drug benefit called Medicare Part D was made available. Coverage is available only through insurance companies and HMOs, and is voluntary. Enrollees paid the following initial costs for the initial benefits: a minimum monthly premium of $24.80 (premiums may vary),

neg: Pharmaceutical lobby from directly negotiating prices with drug companies who provide those prescription drugs covered by Medicare. Price negotiations are instead conducted between manufacturers and the pharmacy benefit managers providing Medicare Part D benefits under contract with Medicare. In 2010 the Congressional Budget Office estimated the average discount negotiated by pharmacy benefit managers at 14%. The high price of U.S. prescription drugs has been a source of ongoing controversy. Corporations state that the high costs are the result of pricey research and development programs. Critics point to the development of drugs having only small incremental benefit. According to Marcia Angell, the former

neg: 2006 Ohio's 2nd congressional district election reform, including a comprehensive Medicare prescription drug benefit to give America's seniors access to affordable prescription drugs. Now that the program is off the ground, the evidence is in and we have much to celebrate: the Medicare prescription drug benefit is working, and seniors are saving money. Over 90 percent of all Medicare beneficiaries now have drug coverage - that's 38 million seniors. As of this summer in Ohio, 1.4 million more seniors have prescription drug coverage than before the benefit began." Wulsin ran a television advertisement using the widely broadcast footage of Schmidt criticizing Democratic Representative John Murtha, a

neg: 2006 Ohio's 2nd congressional district election a half years ago, Congress delivered on a promise we made to the American people by passing sweeping Medicare reform, including a comprehensive Medicare prescription drug benefit to, for the first time, give America’s seniors access to affordable prescription drugs. As we have now passed the May 15 deadline, the evidence is in and we have much to celebrate: the Medicare prescription drug benefit is working, and seniors are saving money." In comparison, the first paragraph of Schmidt's op-ed states that: " Two-and-a-half years ago, Republicans delivered on a promise we made to the American people by passing sweeping Medicare

neg: Medicare Prescription Drug, Improvement, and Modernization Act replaced and expanded the previous Medical Savings Account law by expanding allowable contributions and employer participation. After the first 10 years over 12 million Americans were enrolled in HSAs (AHIP;EBRI). While nearly all agreed that some form of prescription drug benefit would be included, other provisions were the subject of prolonged debate in Congress. The complex legislation also changed Medicare in the following ways: In addition, the legislation mandated a major overhaul of how Part A and Part B claims are processed. Under the new legislation, the FI's and carriers would be replaced by Medicare Administrative Contractors (MAC's), serving both

neg: Medicare (United States) Part A or B is eligible for Part D, which covers mostly self-administered drugs. It was made possible by the passage of the Medicare Modernization Act of 2003. To receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with integrated prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies and pharmacy benefit managers. Unlike Original Medicare (Part A and B), Part D coverage is not standardized (though it is highly regulated by the

neg: 2006 Oregon Ballot Measure 44 At the time the measure was passed, existing law authorized the program's administrator to negotiate price discounts, to purchase prescription drugs on behalf of participants, and to reimburse pharmacies. At the time, only Oregon residents over age 54 whose gross annual income did not exceed 185% of federal poverty guidelines and who had not had private prescription drug benefit coverage for the past 6 months were eligible to participate in the Program. Measure 44 eliminated those restrictions and expands Program eligibility to all Oregon residents who have no prescription drug coverage except Medicare Part D. Ballot Measure 44 modified the

neg: Medicare Part D The cost of the plan would be borne by drug manufacturers for name-brand drugs and by the government for generics. Medicare Part D Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums (the cost of almost all professionally administered prescriptions is covered under optional Part B of United States Medicare). Part D was originally proposed by President Clinton in 2000 and enacted as part of the Medicare Modernization Act of 2003 (which also made changes to the public

neg: Financial gerontology and the financing of long-term care (AIFG 107). Substantial Medicare changes were enacted in 2003 in the Medicare Modernization Act, especially its central policy and financial innovation, the Part D prescription drug benefit to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. In response to requests and advice from both prior and potential students, in collaboration with a health care attorney specializing in public programs, in 2006 AIFG created and offered AIFG 110, "Gerontology and the New Medicare." The course includes a detailed history of Medicare, including distinctions between Medicare and Medicaid; a review

neg: Dan Rostenkowski 1988). The 1988 Catastrophic Act focused on providing protection against catastrophic medical expenses under Medicare. Specifically, the Act expanded the Medicare program to provide protection against catastrophic medical expenses and for the first time, provided coverage under the Medicare program for prescription drugs. To pay for these benefit expansions, a new supplemental premium tax on all persons eligible for Medicare was enacted. After massive protests by seniors, the law was repealed starting the next year. Omnibus Budget Reconciliation Act of 1989, Public Law. 101-239 (December 19, 1989). The 1989 Act was yet another deficit-reduction bill which made several changes to

neg: Health Net It was discovered missing from the company's Connecticut office. Health Net circulated a letter to customers in December 2009, including an offer of free credit protection from a company called Debix for two years. On November 19, 2010, the Centers for Medicare and Medicaid Services (CMS) immediately suspended Health Net because the insurer improperly administered the Medicare drug benefit in contracts for its national prescription drug plan and local Medicare Advantage prescription drug plans. The suspension required Health Net to cease marketing and enrollment of new members of all Health Net Medicare Advantage Prescription Drug (MAPD) and stand-alone Prescription Drug

neg: Heather Bresch received frequent promotions during the following years, "working hard and learning the industry inside out". From 2002 to 2005, Bresch served as Mylan's director of government relations. She contributed to the development of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which created Medicare Part D, a prescription-drug benefit. In 2006 Bresch testified before the U.S. Senate Special Committee on Aging to lobby for changes to the law that would prevent pharmaceutical companies from raising challenges to the introduction of generic competitors by filing citizen's petitions with the FDA, and that would prevent pharma companies from undercutting the

neg: Federal Employees Health Benefits Program original Medicare. In Medicare, premiums, benefits, and payment rates are all centrally determined by law or regulation (there is no bargaining and no reliance on volume discounts in original Medicare; these parameters are set by fiat). Some have criticized the FEHB model because neither the monopsony power nor purchasing power of the federal government is utilized to control costs. This controversy is similar to that which surrounded legislation for the Medicare Prescription Drug Coverage passed during the George W. Bush administration. Over time, however, the FEHB program has outperformed original Medicare not only in cost control, but also in benefit

neg: Economic policy of Donald Trump measures that would reduce the value of the existing debt, making it cheaper to repurchase, would increase the cost of issuing new debt. Such a threat also could undermine the stability of global financial markets." Trump has called for allowing Medicare to negotiate directly with prescription-drug companies to get lower prices for the Medicare Part D prescription-drug benefit, something currently prohibited by law. Trump has claimed on several occasions that this proposal would save $300 billion a year. Glenn Kessler, the fact-checker for the "Washington Post", gave this statement a "four Pinocchios" rating, writing that this was a "truly absurd"

neg: Medigap penalty. The only exception is for the few beneficiaries holding a Medigap policy with a drug benefit that is considered "creditable coverage" (i.e. that it meets four criteria defined by the Centers for Medicare and Medicaid Services); a Medigap policy with prescription drug coverage bought before mid-1992 may pay out as much as or more than a Medicare Part D plan. Medigap policies sold in Massachusetts, Minnesota, and Wisconsin with prescription coverage may also pay out as much as or more than Part D. Thus, individuals who qualify for the Qualified Medicare Beneficiary (QMB) program generally also do not need,

neg: Specialty drugs in the United States the Medicare Prescription Drug, Improvement, and Modernization Act was enacted—the largest overhaul of Medicare in the public health program's 38-year history—included Medicare Part D an entitlement benefit for prescription drugs, through tax breaks and subsidies. In 2004 the U. S. Centers for Medicare and Medicaid Services (CMS) prepared a report on final guidance regarding access to drug coverage enacted under in which they included the specialty drugs tier in the prescription drug formulary. At that time CMS guidelines included four tiers: tier 1 includes preferred generics, tier 2 includes preferred brands, tier 3 includes non-preferred brands and generics and tier

neg: Medicare Part D coverage gap Medicare benefit breakdown (including the doughnut hole) for 2018. The costs shown in the table above represent the 2018 defined standard Medicare Part D prescription drug plan parameters released by the Centers for Medicare and Medicaid Services (CMS) in April 2017. Individual Medicare Part D plans may choose to offer more generous benefits but must meet the minimum standards established by the defined standard benefit. The 2018 Medicare Part D standard benefit includes a deductible of $405 (the amount that beneficiaries must pay out of pocket before their insurance benefits kick in) and a 25% co-insurance up to the initial

neg: Tommy Thompson legislation of President Bush's first term, Thompson frequently served as the president's point man. National analysts cite the passage of Medicare reform as the most important achievement of Thompson's tenure as HHS secretary. As part of the debate over the adoption of Medicare Part D, Thompson was involved in a dispute over whether the Center for Medicare and Medicaid Services had to share cost estimates to Congress for legislation that would create a prescription drug benefit. Critics accused Thompson and HHS of downplaying the true cost of the law by $150 billion. CMS Administrator Tom Scully threatened to fire a

neg: Presidency of George W. Bush conservative Republicans also opposed the expansion of a government program. Along with House Speaker Dennis Hastert, he narrowly won approval of the bill in the House, while Senate Majority Leader Bill Frist overcame strong opposition in the Senate. In December 2003, Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act, the largest expansion of Medicare since the program's creation in 1965. After winning re-election in 2004, Bush called for changes in Social Security as part of his vision of an "ownership society." He wanted to restructure the program for citizens to invest some of the money going in to

neg: Specialty drugs in the United States 4 included specialty drugs. By January 1, 2006, the controversial Medicare Part D was put in effect. It was a massive expansion of the federal government's provision of prescription drug coverage to previously uninsured Americans, particularly seniors. In 2006 in the United States there was no standard nomenclature, so sellers could call the plan anything they wanted and cover whatever drugs they wanted. By 2008 most prescription medication plans in the United States used specialty drug tiers, and some had a separate benefit tier for injectable drugs. Beneficiary cost sharing was higher for drugs in these tiers. By 2011 in

neg: Medicare Rights Center City community-based organizations in need of Medicare counseling and enrollment assistance. Later that year, Medicare Rights launched the Baltimore Project, which systematically linked helpline stories to needed policy reforms, and helped increase the organization's visibility as a policy voice with the Centers for Medicare & Medicaid Services (CMS). Also this year, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was enacted, paving the way for the Medicare Advantage program and the Medicare Part D drug benefit. In 2005, the Medicare Part D drug benefit became available in the fall (with the first-ever Fall Open Enrollment Period running from November

neg: Medigap first dollar coverage plans will save Medicare money. Some Medigap policies sold before January 1, 2006 may include prescription drug coverage, but after that date, no new Medigap policies could be sold with drug coverage. This time frame coincides with the introduction of the Medicare Part D benefit. Medicare beneficiaries who enroll in a Standalone Part D plan may not retain the drug coverage portion of their Medigap policy. People with Medigap policies that include drug coverage who enrolled in Medicare Part D by May 15, 2006 had a guaranteed right to switch to another Medigap policy that has no

neg: Jim Talent add of renewable fuels to the national supply by 2012, including a measure to include tax credits for businesses offering soybean-based fuels. In addition to renewable fuels, Talent supported drilling in the Arctic as a step in the direction of energy independence, which he sees as critical to national security. Talent supported the Medicare prescription drug benefit called Medicare Part D, the purpose of which is to reduce the amount seniors pay for their prescription drugs. Talent called for waiving a one percent penalty for senior citizens who missed the deadline to sign up for the program. Talent voted against

neg: George W. Bush Bush signed into law a Medicare drug benefit program that, according to Jan Crawford, resulted in "the greatest expansion in America's welfare state in forty years;" the bill's costs approached $7 trillion. In 2007, Bush opposed and vetoed State Children's Health Insurance Program (SCHIP) legislation, which was added by the Democrats onto a war funding bill and passed by Congress. The SCHIP legislation would have significantly expanded federally funded health care benefits and plans to children of some low-income families from about six million to ten million children. It was to be funded by an increase in the cigarette tax.

neg: Pharmaceutical Benefits Scheme noted as "authority required benefits" on the Schedule. Again, the PBAC has deemed that the cost-benefit analysis is favourable only under in specific indications/patients under certain circumstances. Authority may be obtained by telephone to Medicare Australia (known as "phone approval") or in writing from an authorised delegate of the Minister for Health. Prescriptions must be written on Authority Prescription Form, and the approval number must be noted on the prescription. Pharmacists cannot dispense the item as a pharmaceutical benefit unless it has been approved by Medicare Australia (indicated by the presence of the approval number). In obtaining a phone approval,

neg: Political positions of Mitt Romney for the governorship of Massachusetts in 2002, Romney argued that the federal government should pay for medicines for seniors: "It is outrageous that some senior citizens are forced to choose between paying for their prescription drugs and their groceries. The federal government needs to step in with a plan for our senior citizens, and I will lobby officials on the federal level to provide a Medicare drug benefit." (The U.S. Congress would pass legislation providing for Medicare prescription drug coverage - Medicare Part D - the following year.) In February 2012, in an address to the Detroit Economic Club during

neg: Newt Gingrich and writing, and midday zoo trips—and even he will admit, 'It’s a very fun life.' The world may be burning, but Newt Gingrich is enjoying the spoils." In 2003, he founded the Center for Health Transformation. Gingrich supported the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, creating the Medicare Part D federal prescription drugs benefit program. Some conservatives have criticized him for favoring the plan, due to its cost. However, Gingrich has remained a supporter, stating in a 2011 interview that it was a necessary modernization of Medicare, which was created before pharmaceutical drugs became standard in medical

neg: Mark McClellan to 2006. In this position, he was responsible for administering the Medicare and Medicaid programs, including Medicare Part D, the prescription drug benefit program engendered by the Medicare Prescription Drug, Improvement, and Modernization Act. Following the resignation of Health & Human Services Secretary Tommy Thompson in 2004, McClellan was mentioned as a possible replacement, but President Bush ultimately nominated former Utah governor Mike Leavitt. On September 5, 2006, McClellan announced his resignation from his post in the department. He told The Associated Press he would be leaving the agency in about five weeks and would probably work for a think

neg: Electronic Prescriptions for Controlled Substances to examine how to revise its rules to allow electronic prescriptions for controlled substances. The DEA had to mindful that regulations on electronic prescriptions must be consistent with other statutory mandates and Federal regulations. Looking back, "E-Sign" was signed into law on June 30, 2000. It establishes the basic rules for using electronic signatures and records in commerce, and it electronic commerce by giving legal effect to electronic signatures and records and to protect consumers. In 2003, the "Medicare Prescription Drug, Improvement, and Modernization Act" was implemented. It contained a requirement pertaining to electronic transmission of prescriptions and prescription-related information

neg: Medicare dual eligible mandatory levels (i.e., offer home and community-based services), and accordingly state Medicaid programs vary in scope. Dual-eligibles may be categorized as full-benefit or partial-benefit. Those with full benefits may receive the entire range of Medicaid benefits; those with partial-benefits do not receive Medicaid-covered services, but Medicaid covers their Medicare premiums or cost-sharing, or both. Partial benefit dual-eligible beneficiaries have limited income and assets, but their income and assets are not low enough to qualify them for full Medicaid benefits in their state. With the advent of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, these dual eligibles have

neg: Political positions of Newt Gingrich quality, medical outcomes or price". Gingrich supported the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, creating the Medicare Part D federal prescription drugs benefit program. While he has received some criticism from conservatives over the cost of the plan, Gingrich has reiterated his support in years since, saying that it represented necessary modernization of the system, as Medicare was created in the 1960s, before pharmaceutical drugs were in widespread use. He also stated that the costs of providing medication must be balanced against the decreased need for medical procedures. The same year, Gingrich founded the Center for Health

neg: Drug coupon of 2003 (MMA) put Medicare Part D into effect on January 1, 2006, expanding Medicare benefits to include subsidized prescription products for Medicare beneficiaries in the United States. Drug coupons may not be used for prescription products paid for in full or in part by any government sponsored insurance such as Medicare Part D, Medicaid, MediCal Tricare, etc. However, patients in the so-called Medicare Part D "doughnut hole" who pay cash for their medication may use coupons. Citation needed Coupons are prevalent in product categories where there is a lot of competition, such as dermatology products, lipid modifying agents and

neg: Medicare Advantage many of the other public managed-care health plans within Medicare Part C) include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan. The federal government makes separate capitated-fee payments to Medicare Advantage plans for providing these Part-D-like benefits if applicable just as it does for anyone on Original Medicare using Part D. Nearly all Medicare beneficiaries (99%) had access to at least one Medicare Advantage plan; the average beneficiary had access to 18 plans in 2015. In the 1970s, less than a decade after the beginning of fee for service Medicare, Medicare beneficiaries gained the

neg: Medicare Advantage option to receive their Medicare benefits through managed, capitated health plans, mainly HMOs, as an alternative to FFS Original Medicare, but only under random Medicare demonstration programs. The Balanced Budget Act of 1997 formalized the demonstration programs into Medicare Part C, introduced the term "Medicare+Choice" as a pseudo-brand for this option. Initially, fewer insurers participated than expected, leading to little competition. In a 2003 law, the capitated-fee benchmark/bidding process was changed effective in 2005 to increase insurer participation, but also increasing the costs per person of the program. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 renamed +Choice

neg: Medicare Part D The Medicare Modernization Act (MMA) established a standard drug benefit that all Part D plans must offer. The standard benefit is defined in terms of the benefit structure and without mandating the drugs that must be covered. For example, in 2013, the standard benefit required payment by the beneficiary of a $325 deductible, then required 25% coinsurance payment by the beneficiary of drug costs up to an initial coverage limit of $2,970 (the full retail cost of prescriptions). Once this initial coverage limit is reached, the beneficiary had to pay the full cost of his/her prescription drugs up until the

neg: Humana mailings to elderly Medicare recipients. The mail was made to appear to contain official information about Medicare Advantage and prescription drug benefit information, but instead alleged that core Medicare benefits could be cut by the Obama administration's healthcare reform, a claim refuted by John Rother, AARP's executive vice president. Douglas Elmendorf, the head of the Congressional Budget Office (CBO) supported the claim that Medicare benefits could be cut, but his comments were in reference to just one of several congressional bills. CBO estimates of another healthcare reform bill found that changes to premiums would vary. The Centers for Medicare and

neg: Surescripts Surescripts Surescripts is an Arlington, Virginia based information technology company that supports e-prescription, the electronic transmission of prescriptions between health care organizations and pharmacies, as well as general health information exchange (HIE) of medical records. Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Surescripts took part in a pilot program with the Centers for Medicare & Medicaid Services (CMS) to employ the SCRIPT standard. In 2008, Surescripts merged with RxHub which was formed by a consortium of pharmacy benefit management companies comprising CVS Caremark, Express Scripts and Medco Health Solutions. According to the U.S. Department of Health

neg: PAYGO Tax Relief Reconciliation Act of 2003), and the Medicare Prescription Drug, Improvement, and Modernization Act. The White House acknowledged that the new Medicare prescription drug benefit plan would not meet the PAYGO requirements: After the expiration of PAYGO, budget deficits returned. The federal surplus shrank from $236.2 billion in 2000 to $128.2 billion in 2001, then a $157.8 billion deficit in 2002—the last year statutory PAYGO was in effect. The budget deficit increased to $377.6 billion in 2003 and $412.7 billion in 2004. The federal budget deficit excluding trust funds was $537.3 billion in FY2006. In the first 6 years

neg: Todd Akin don't know if you can prove...". In his early years in Congress, Akin brought back earmarks for his district, voted to raise the debt ceiling, voted for off-balance-sheet wars in Iraq and Afghanistan, and voted to create the unfunded Medicare prescription drug benefit. More recently, he has opposed increases in taxation and spending. He voted in 2007 against an expansion of the State Children's Health Insurance Program (SCHIP), objecting to its potential coverage of children in families making up to $62,000 a year, and stating that proof of U.S. citizenship was not required. He also said the bill would "weaken

neg: Pharmacy benefit management Pharmacy benefit management In the United States, a pharmacy benefit manager (PBM) is a third-party administrator (TPA) of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), and state government employee plans. As of 2018 they have become industrial behemoths in the US health sector. According to the American Pharmacists Association, "PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims. For the most part, they work with self-insured companies and

neg: Tommy Thompson for a bio-terrorism attack, by stockpiling smallpox vaccines and investing heavily in state and local public health infrastructure. Thompson's major initiatives were "efforts to strengthen U.S. preparedness for a bioterrorism attack, increase funding for the National Institutes of Health, expand health insurance coverage to lower-income Americans, and focus attention on health problems such as obesity and diabetes." Thompson was one of the key architects of the 2003 passage of Bush's Medicare Modernization Act, which was slated to provide public funding for prescription drugs for Medicare recipients starting in 2006. On the prescription drug-benefit issue, the major piece of health care

neg: Political positions of Paul Ryan the policy debates of the period 2010-2012. Ryan's non-fiscal policy positions were subject to additional national attention with his 2012 race for Vice President. Ryan does not believe government subsidized health care is a right or privilege. In 2012, "The New York Times" said Ryan was "his party's most forceful spokesman for cutting entitlement spending." On March 17, 2017, Ryan said "Medicaid, sending it back to the states, capping its growth rate" was a long-time dream of his. Though he voted for the 2003 Medicare Prescription Drug, Improvement, and Modernization Act that created the Medicare Part D prescription drug benefit,

neg: Drug coupon in a variety of ways such as instant savings offers, free trial offers (also known as try-before-you-buy offers), copay reduction or rebates. Generic drug companies rarely offer coupons, though insurance companies occasionally offer discounts on generic drugs. In addition PBMs (Pharmacy Benefit Managers) offer discount cards that act similarly to coupons. These cards work for both generic and brand medications and can save cash paying customers up to 75% on their prescription medication. Medicare was designed by the U.S. government in 1965 to help senior citizens and the disadvantaged afford health care. The Medicare Prescription Drug, Improvement, and Modernization Act

neg: Health insurance in the United States plans cost 12% more than traditional Medicare. The ACA took steps to align payments to Medicare Advantage plans with the cost of traditional Medicare. There is some evidence that Medicare Advantage plans select patients with low risk of incurring major medical expenses to maximize profits at the expense of traditional Medicare. Medicare Part D provides a private insurance option to allow Medicare beneficiaries to purchase subsidized coverage for the costs of prescription drugs. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and went into effect on January 1, 2006. Medicaid was

neg: SGR Repeal and Medicare Provider Payment Modernization Act of 2014 health professional utilization and expenditures (and their rate of increase) of items and services for which Medicare payment is made, and (2) total utilization and expenditures (and their rate of increase) under Medicare parts A (Hospital Insurance), B (Supplementary Medical Insurance), and D (Voluntary Prescription Drug Benefit Program). The bill would direct MEDPAC to report to Congress on: (1) the payment update for professional services applied under Medicare for 2014 through 2018, (2) the effect of such update on the efficiency, economy, and quality of care provided under such program, (3) the effect of such update on ensuring a sufficient

neg: EHealthInsurance or older, or persons with disability under the Social Security Act for two years or longer. Persons with medicare will often obtain a prescription drug plan. This is often incorporated into a Medicare Advantage plan that persons are eligible for when new to Medicare, if they move to a new area, or annually during the annual enrollment period between October 15 to December 7 of every year. eHealth markets, under various electronic platforms, the various medicare plans such as Medicare Advantage, Medicare supplement, and prescription drug plans (PDP). In 2018, eHealth acquired GoMedigap, which was a consumer acquisition and engagement

neg: Medicare Prescription Drug, Improvement, and Modernization Act Parts A and B, and would be consolidated into fifteen Jurisdictions: Four "Specialty MAC Jurisdictions" were also created to handle durable medical equipment and home health/hospice claims: Finally, the underlying contracts would be subject to competition, and would also be subject to the requirements of the Cost Accounting Standards and the Federal Acquisition Regulation. According to the New York Times December 17, 2004 editorial W.J."Billy" Tauzin, the Louisiana Republican who chaired the Energy and Commerce Committee from 2001 until February 4, 2004 was one of the chief architects of the new Medicare law. In 2004 Tauzin was appointed as chief

neg: Consumer-driven healthcare had their origin in the U.S. in the late 1990s. It was developed as a business model for health ventures. They were designed to engage consumers more directly in their healthcare purchases. The initial conceptual model made cost and quality information available to the consumer, usually through the Internet. HSAs are seen by proponents as a way to make healthcare more affordable and accessible in the U.S. The Medicare Prescription Drug, Improvement, and Modernization Act, which included provisions designed to stimulate the popularity of these plans, was passed by Congress in November 2003 and signed into law by President Bush

neg: Nancy Johnson care. She was one of the authors of the Medicare Part D prescription drug benefit program, which took effect in 2006. On May 15, 2006, Johnson announced she would submit legislation to waive penalties for those who miss deadlines to enroll in Medicare Part D, reacting to widespread criticism of the Johnson-authored program. Her bill was supported by the AARP. With the retirement of Ways and Means Committee chairman Bill Thomas (R-CA) at the end of his term, Johnson was a possible candidate to replace him as chairman if Republicans were to retain the House and Johnson retain her seat

neg: Alliance for Retired Americans has also clashed with AARP. The Alliance has often said it is not a competitor with AARP; and, that it wishes to work in cooperation with the much larger seniors' group. However, during the 2003 debate over the Medicare prescription drug benefit, the Alliance broke with AARP and publicly criticized AARP's leaders for being out of touch with seniors and caving in to financial incentives (AARP offers a number of health insurance products, some of which might have suffered had a more generous prescription drug benefit been enacted). Membership in the Alliance is defined quite broadly. Members of NCSC were

neg: Starve the beast in the Medicare payroll tax rate to pay for the prescription drug benefit, both initiatives would have been less popular. Given that the prescription drug benefit only passed Congress by one vote after an extraordinary amount of arm-twisting, it seems unlikely that it would have passed at all if accompanied by a tax increase. Starve the beast doesn't work." Economist Paul Krugman summarized as: "Rather than proposing unpopular spending cuts, Republicans would push through popular tax cuts, with the deliberate intention of worsening the government's fiscal position. Spending cuts could then be sold as a necessity rather than a choice,

neg: Pharmacy benefit management enrollees. A pharmacy benefit management company is a third-party administrator of prescription drug programs for commercial health plan, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans (i.e. plan sponsors). By their own description through their trade association Pharmaceutical Care Management Association, PBMs aggregate the buying clout of enrollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs through price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and mail-service pharmacies which home-deliver prescriptions without consulting face-to-face with a pharmacist. For example,

neg: Medicare (Canada) (e.g., HIV/AIDS, cancer, cystic fibrosis). Unlike a number of other countries with universal health insurance systems, Canada lacks a universal pharmaceutical subsidy scheme, with co-payment, cost ceilings, and special subsidy groups varying by private insurer and by province. Each province may provide its own prescription drug benefit plan, although the Canada Health Act requires only coverage for pharmaceuticals delivered to hospital inpatients. Provincial prescription drug benefit plans differ across provinces. Some provinces cover only those in particular age groups (usually, seniors) and/or those on social assistance. Others are more universal. Quebec achieves universal coverage through a combination of private and

neg: History of health care reform in the United States in this manner proved rather provocative. In fact, many interest groups, including the American Medical Association (AMA) and the pharmaceutical industry came out vehemently against the congressional bill. Basically, providing emergency medical care to anyone, regardless of health insurance status, as well as the right of a patient to hold their health plan accountable for any and all harm done proved to be the biggest stumbling blocks for this bill. As a result of this intense opposition, the Patients' Bill of Rights initiative eventually failed to pass Congress in 2002. As president, Bush signed into law the Medicare Prescription Drug,

neg: Methadone used name for the drug) appeared in the United States in the early 1970s as a reference to the aforementioned urban myth that the trade name Dolophine was a reference to Adolf Hitler. Brand names include Dolophine, Symoron, Amidone, Methadose, Physeptone, Metadon and Heptadon among others. In the US, generic methadone tablets are inexpensive, with retail prices ranging from $0.25 to $2.50 per defined daily dose. Brand-name methadone tablets may cost much more. Methadone maintenance clinics in the US may be covered by private insurances, Medicaid, or Medicare. Medicare covers methadone under the prescription drug benefit, Medicare Part D, when

neg: Medicare Prescription Drug, Improvement, and Modernization Act that the cost would actually be over $500 billion. One month after passage, the administration estimated that the net cost of the program over the period between 2006 (the first year the program started paying benefits) and 2015 would be $534 billion. As of February 2009, the projected net cost of the program over the 2006 to 2015 period was $549.2 billion. Since the enactment of Medicare Prescription Drug, Improvement, and Modernization Act in 2003, only insurance companies administering Medicare prescription drug program, not Medicare, have the legal right to negotiate drug prices directly from drug manufacturers. The Medicare Prescription

neg: Implementation history of the Patient Protection and Affordable Care Act Implementation history of the Patient Protection and Affordable Care Act The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. Once the law was signed, provisions began taking effect, in a process

neg: Medicare Prescription Drug, Improvement, and Modernization Act was actually considered to have a credible chance of passing. For several minutes, the vote total was stuck at 58-39, until Senators Lindsey Graham (R-SC), Trent Lott (R-MS), and Ron Wyden (D-OR) voted in quick succession in favour to pass the vote 61-39. The bill itself was finally passed 54-44 on November 25, 2003, and was signed into law by the President on December 8. Initially, the net cost of the program was projected at $400 billion for the ten-year period between 2004 and 2013. Administration official Thomas Scully instructed analyst Richard Foster not to tell Congress of Foster's finding

neg: Special needs plan Special needs plan A special needs plan (or SNP, often pronounced "snip") is a category of the US Medicare Advantage plan designed to attract and enroll Medicare beneficiaries who fall into a certain special needs demographic. There are two types of SNPs. The exclusive SNP enrolls only those beneficiaries who fall into the special needs demographic. The other type is the disproportionate share SNP. "Disproportionate share" SNPs enroll a greater percentage of the target special needs population as compared to a national percentage of the target population. Under the federal �Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Congress

neg: First 100 days of Donald Trump's presidency Trump had pledged to revert this. Following the morning meeting with CEOs on January 31, Trump abandoned his pledge to allow "Medicare negotiate bulk discounts in the price it pays for prescription drugs." On January 28, Trump signed an Executive Order to fulfilling his campaign pledge to limit lobbying of executive agency members. On February 8, Alabama Senator Jeff Sessions, who was nominated by Trump in January, was confirmed as United States Attorney General (A.G.), the head of the Justice Department per . He is the United States government's chief law enforcement officer and lawyer with 113,000 employees working under

neg: Tom Feeney Unlawful Internet Gambling Enforcement Act while the U.S. Treasury Department and the Federal Reserve defined "unlawful Internet gambling"). Despite his ties to the Bush family, Feeney broke with the White House and opposed the Medicare reform package of 2003 since he felt its centerpiece, a prescription drug benefit for senior citizens, was too expensive. He was a founding member of Washington Waste Watchers, a government spending watchdog group. Feeney cosponsored a non-binding resolution against the use of foreign law in federal courts. When Supreme Court Justice Antonin Scalia said (of the resolution) that "[i]t's none of your business", Feeney said

neg: Medicare (United States) care; and the costs related to basic Medicare's lifetime and per-incident limits. Medicare is divided into four Parts. Medicare Part A covers hospital (inpatient, formally admitted only), skilled nursing (only after being formally admitted to a hospital for three days and not for custodial care), and hospice services. Part B covers outpatient services including some providers' services while inpatient at a hospital, outpatient hospital charges, most provider office visits even if the office is "in a hospital," and most professionally administered prescription drugs. Part D covers mostly self-administered prescription drugs. Part C is an alternative called Managed Medicare by the

neg: Pete Gallego Gallego's support for the Affordable Care Act has been attacked in advertisements by the Libre Initiative, a conservative Hispanic outreach group. Gallego opposes a Medicare voucher system and says that he supports Medicaid expansion and prescription drug negotiations. Gallego supported an abortion law allowing minors to get an abortion with parental consent. Under the legislation a minor would have been able to bypass the requirement for parental consent by petitioning a judge. Gallego has said that border security and immigration reform are two separate issues. He advocates improved "worker accountability programs, using border security as an economic tool and aiding

neg: Medicare Part D (NOTE: Medicare beneficiaries need to be signed up for both Parts A and B to select Part C whereas they need only A or B to select Part D.) About two-thirds of all Medicare beneficiaries are enrolled directly in Part D or get Part-D-like benefits through a public Part C Medicare health plan. Another large group of Medicare beneficiaries get prescription drug coverage under plans offered by former employers or through the Veterans Administration. It is also possible that a former employer or union might sponsor a Part D plan for former employees/members (such plans are called Employer Group Waiver

neg: Medicare (United States) as a model of lower cost prescription drug coverage. Since the VHA provides healthcare directly, it maintains its own formulary and negotiates prices with manufacturers. Studies show that the VHA pays dramatically less for drugs than the PDP plans Medicare Part D subsidizes. One analysis found that adopting a formulary similar to the VHA's would save Medicare $14 billion a year (over 10 years the savings would be around $140 billion). There are other proposals for savings on prescription drugs that do not require such fundamental changes to Medicare Part D's payment and coverage policies. Manufacturers who supply drugs to

neg: Domestic policy of the George W. Bush administration There were 463,000 fewer private-sector payroll jobs when he left office than when he came into office. In 2004, a full chapter on Iraq's economy was excised from the Economic Report of the President, in part because it doesn't fit the "feel good" tone of the writing, according to White House officials. In July 2002, Bush cut off U.S. funding to the United Nations Population Fund (UNFPA). Bush stated that the UNFPA supported forced abortions and sterilizations in the People's Republic of China. Bush signed the Medicare Act of 2003, which added prescription drug coverage to Medicare (United States), subsidized

neg: Medicare Part D coverage gap Medicare Part D coverage gap The Medicare Part D coverage gap (informally known as the Medicare doughnut hole) is a period of consumer payment for prescription medication costs which lies between the initial coverage limit and the catastrophic-coverage threshold, when the consumer is a member of a Medicare Part D prescription-drug program administered by the United States federal government. The gap is reached after shared insurer payment - consumer payment for all covered prescription drugs reaches a government-set amount, and is left only after the consumer has paid full, unshared costs of an additional amount for the same prescriptions. Upon

neg: Protecting Access to Medicare Act of 2014 Protecting Access to Medicare Act of 2014 The Protecting Access to Medicare Act of 2014 (; ) is a law that delayed until March 2015 a pending cut to Medicare physician payment, a cut that had been regularly delayed for over a decade. Because the law only delayed and did not repeal the physician payment cut, it was a source of controversy. The bill was signed into law on April 1, 2014, during the 113th United States Congress. In the United States, Medicare is a national social insurance program, administered by the U.S. federal government since 1966, that guarantees access

neg: Orrin Hatch was part of the group of 13 Senators drafting the Senate version of the AHCA behind closed doors. In 2003, Hatch supported the Medicare prescription drug benefit plan known as Medicare Part D. Responding to criticism of the legislation during the 2009 debate on health care reform, Hatch said that in 2003 "it was standard practice not to pay for things" and that although there was concern at the time about increasing the deficit, supporting the bill was justified because it "has done a lot of good". On March 25, 2014, Hatch cosponsored the Emergency Medical Services for Children Reauthorization

neg: Jim Ryun support fiscal restraint. Ryun broke with the President over two major initiatives, No Child Left Behind and Medicare reform legislation that included a prescription drug benefit. In voting against No Child Left Behind, Ryun said he believed states should have more control over their own education system. In opposing the Medicare bill, Ryun said the bill didn't provide enough reform to keep future costs from soaring. In 2006, the "National Journal" rated Ryun as the nation's most conservative member of Congress. He was a member of the Republican Study Committee, a caucus of 103 fiscally and socially conservative House Republicans.

neg: Compassionate conservatism as leading to the Bush administration's increased government spending, saying that it "completely betrayed conservative voters and their decades of grassroots activism," and "alienated the party's conservative base," noting Bush policies such as the Medicare prescription-drug benefit, which increased the size of the Medicare program by around $500 billion. In 2006, conservative commentator Jonah Goldberg has written that compassionate conservatism as implemented by George W. Bush differs markedly from the theoretical concept: "As countless writers have noted in National Review over the last five years, most conservatives never really understood what compassionate conservatism was, beyond a convenient marketing slogan to

neg: Paul Ryan benefits, to give states and local jurisdictions a greater role in administering those benefits, to better measure the results of federal programs for the poor, and to crack down on waste, fraud and abuse." Ryan believes federal poverty reduction programs are ineffective and he supports cuts to welfare, child care, Pell Grants, food stamps, and other federal assistance programs. Ryan supports block granting Medicaid to the states and the privatization of social security and Medicare. Ryan supported the Medicare Part D prescription drug benefit and opposes the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare." Ryan supported

neg: Annual enrollment or join or change plans within the Medicare Advantage and Medicare Part D Prescription Drug programs for the coming calendar year. Individuals usually can make changes to, or sign up for, their health insurance or fringe benefits only once per year during the annual enrollment period or when they have experienced a specific qualifying event. During this time period, an employer will typically communicate to all eligible employees what options they have for their benefit program. Often the vendors or insurance providers will be present to explain the details of their products. This can be done either with group presentations,

neg: Tommy Thompson CMS actuary if he revealed to Congress his estimate. Investigators determined that the data was improperly hidden from Congress, but did not conclude whether laws had been broken. In 2011 the trustees of Medicare found that the prescription drug benefit had come in 40% below estimates, the Congressional Budget Office (using different budgeting numbers) determined that the program had come in 28% below projections. In her Senate campaign, Rep. Tammy Baldwin (D-WI) said in 2012 that Thompson was resonsible for forbidding Medicare to negotiate drug prices, a statement that Politifact rated as "True." Thompson said that he had nothing to

neg: Medicare Prescription Drug, Improvement, and Modernization Act Medicare plan (Parts A and B). These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the compensation and business practices for insurers that offer these plans changed, and "Medicare+Choice" plans became known as "Medicare Advantage" (MA) plans. In addition to offering comparable coverage to Part A and Part B, Medicare Advantage plans may also offer Part D coverage. With the MMA, new Medicare Advantage plans were established with several advantages over the previous Medicare + Choice plans: The MMA created a new Health Savings Account statute that

neg: Medicare (United States) their Medicaid rolls. Ultimately Kaiser found that the plan would raise total social costs by more than twice the savings to the federal government. Negotiating the prices of prescription drugs Currently, people with Medicare can get prescription drug coverage through a public Medicare Part C plan or through the standalone Part D prescription drug plans (PDPs) program. Each plan sponsor establishes its own coverage policies and could if desired independently negotiate the prices it pays to drug manufacturers. But because each plan has a much smaller coverage pool than the entire Medicare program, many argue that this system of paying

neg: Club for Growth support the endorsed candidates. Promoting a more conservative agenda, the Club is known for targeting "establishment" Republican candidates. In 2003, the original Club for Growth strongly opposed the Medicare prescription drug benefit proposal. The Club for Growth strongly supported the Bush tax cuts of 2003 and ran television ads against two Republicans who voiced opposition to the tax cuts. According to "The New York Times", "Last spring, [Club for Growth president Steve] Moore attacked two Republican Senators who were resisting the latest tax cut: George Voinovich of Ohio and Olympia Snowe of Maine. He ran ads in each of their

neg: University of Arizona College of Pharmacy response to the medication therapy management requirement of the Medicare Part D prescription drug benefit. It is a pharmacist-run call center that provides services to Medicare beneficiaries and participates in research on the effects of medication therapy management. In 2013 it won a national Pinnacle Award for improving medication outcomes. University of Arizona College of Pharmacy College of Pharmacy is part of the University of Arizona, a public university in Tucson, Arizona. It is the only pharmacy school at a public Arizona university and one of four health professions colleges at the Arizona Health Sciences Center campus. The college is

neg: Medicare Part D coverage gap entering the gap, the prescription payments to date are re-set to $0 and continue until the maximum amount of the gap is reached OR the current annual period lapses: copayments made by the consumer up to the point of entering the gap are specifically "not" counted toward payment of the costs accruing while in the gap. Provisions of the Patient Protection and Affordable Care Act of 2010 gradually phase out the coverage gap, eliminating it by 2020. In 2006, the first year of operation for Medicare Part D, the doughnut hole in the defined standard benefit covered a range in

neg: Out-of-pocket expense States. Before investing in a health care plan, it is very useful to examine the out-of-pocket prescription costs as they may be very low or very high. High out-of-pocket costs may correlate with lower prescription adherence and more importation of medications from foreign countries. Medicare Part D is a federal program aimed at lowering prescription drug costs for Medicare beneficiaries. However, after the first year of Medicare Part D, out-of-pocket drug costs were down, but there was not a noticeable reduction in emergency department visits, hospitalization, or health utility score. Perhaps, some diseases will be more sensitive to Medicare Part

neg: Political positions of Paul Ryan to welfare, child care, Pell Grants, food stamps, and other federal assistance programs. Ryan supports block granting Medicaid to the states and the privatization of social security and Medicare. Ryan supported the Medicare Part D prescription drug benefit and opposes the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare." Ryan supported the American Health Care Act of 2017 (AHCA), the House Republican plan to repeal and replace the ACA, which passed the House on May 4, 2017. Ryan is pro-life and opposes abortion rights. Ryan opposed the Lilly Ledbetter Fair Pay Act of 2009, which bolstered women's

neg: Mike Pence a supporter of earmark reform. He voted against the $139.7 billion Transportation-Treasury spending bill in June 2006, and in favor of a series of amendments proposed that same month by Jeff Flake which would strip other members' earmarks from the federal budget. On occasion, however, Pence secured earmarks for projects in his district. Pence voted against the act that created Medicare Part D, a Medicare prescription-drug benefit. Pence voted against the Patient Protection and Affordable Care Act. In June 2012, after the U.S. Supreme Court upheld the Affordable Care Act in "NFIB v. Sebelius", Pence likened the ruling to the

neg: Patrick J. Kennedy provide coverage for the treatment of mental illnesses which is no less restrictive than coverage provided for physical illnesses. He was a strong proponent of adding a comprehensive prescription-drug benefit to the U.S. Medicare and consistently opposed attempts to privatize the Medicare program. Kennedy also made numerous speeches advocating the re-orientation of the U.S. health-care system to preventive care. He has received numerous awards for his health care advocacy, including the Lymphoma Research Foundation's Paul E. Tsongas Memorial Award as well as the Leukemia & Lymphoma Society Congressional Honors Award. He also received the Society for Neuroscience — Public Service

neg: Pharmaceutical Benefits Scheme those indications/patients. These are noted as "restricted benefits" on the Schedule. Medicare Australia places the onus of policing restricted benefits on the prescribers themselves and the pharmacists dispensing (unless the listing is also 'Authority Required'). For example, the COX-2 inhibitor celecoxib is listed on the PBS as a restricted benefit for the symptomatic treatment of osteoarthritis and rheumatoid arthritis. Prescribers using celecoxib for other indications are expected to indicate "non-PBS" on the prescription, and/or the pharmacist dispensing the celecoxib should charge the patient the full cost. Some PBS medications are restricted and require prior approval from Medicare Australia. These are

neg: Robert Moffit American newspapers including "The New York Times", "The Wall Street Journal", "The Washington Post" and "The Washington Times", as well as in "The Irish Independent". Moffit's research has also involved him in debates over Medicare reform, how to ensure access to prescription drugs, and how to improve access to private health care coverage. As a longtime advocate of a consumer-driven approach, Moffit recommends that the government adopt a new program for the baby boomers entering Medicare in 2011 similar to the consumer-driven Federal Employees Health Benefit Plan (FEHBP), which allows members of Congress and federal workers to select coverage from

neg: Dennis Hastert the Senate over the 2005 budget. After "McCain gave a speech excoriating both political parties for refusing to sacrifice their tax cutting and spending agendas in wartime," Hastert publicly questioned McCain's "credentials as a Republican and suggested that the decorated Vietnam War veteran did not understand the meaning of sacrifice." Hastert was key to the passage in November 2003 of key Medicare legislation which created Medicare Part D, a prescription-drug benefit. Hastert's push to pass the legislation—culminating in a three-hour House vote in which the Speaker, "an imposing former wrestling coach, was literally leaning on recalcitrant lawmakers to win their