Medicare Part D: (“D” is for Disaster”)

1. Medicare Part D: (“D” is for Disaster”) A Presentation of the Gray Panthers California, produced under a grant from the California Wellness Foundation Margie Metzler 1121 Wayland Avenue Sacramento, CA 916-921-5008 margiemetz@hotmail.com Website: www.gpcal.org February 5, 2006 This program operates under a grant from the California Wellness Foundation

2. Trust the Drug Companies…

3. A Little Humor…

4. Our Motto

5. History Jan. 12006 Nov.2003 1988-89 1993 1965 What a mess! Medicare enacted (drug benefit dropped from orig.) Limited drug benefit enacted; dropped Clinton plan had Drug benefit The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) http://www.medicalnewstoday.com/medicalnews.php?newsid=9859

6. Fire the Truthteller! • Bush, Sec. of HHS Tommy Thompson, and CMS admin. Scully said cost would be < $400 Billion over 10 years. • Richard Foster, Medicare actuary, predicted $600 Billion. He was fired!

7. Bi-Partisanship at its Best! • Democrats couldn’t add amendments. • Vote was held open for three hours in the dead of night until admin. could find 4 supporters. Thompson, DeLay, Bush were allowed on the floor to twist arms. • Demos. found a room and were threatened with eviction. They refused to leave till they got the Bill and slept on the floor. • HR 1 was brought before the House for final passage at 3 a.m. Sat., Nov. 22, 2003.

8. A Night of Infamy… • Bribery and Intimidation: “I was targeted by lobbyists and the congressional leadership to change my vote..” • Censoring C-SPAN • HHS Secretary on the House Floor • Misleading Congress and • Withholding Pivotal Information • Conference Committee Lockout • ”

9. Shame on Them • Tom Scully and Assistant, Jeff Flick (Where are they now?) • Rep. Billy Tauzin and Rep. James Greenwood. • Rep. Nick Smith bribed by Tom DeLay

10. Drug Companies in Action! • In 2003, the Drug Companies… • hired 952 lobbyists • spent $141 million on lobbying • contributed more than $30 million to campaigns. • There were 12 lobbyists for every Congressperson • Drug profits rose $182 billion.

11. What have we got? Can we make it better? • Does Medicare Part D reduce costs & improve access? OR • Does it simply privatize a major part of Medicare and enrich drug manufacturers and insurance companies (while sacrificing the standard benefits fundamental to Medicare?)

12. Medicare Part D – Working for you?

13. Advice in a Nutshell • If you have good coverage in a private plan now, STAY PUT! • Save every piece of paper you get from your current plan, Medicare, Social Security, Medi-Cal etc. Store in a safe place and make backup copies. Check with HICAP.

14. List of the Most Egregious Issues… • Enrollment = Chaos + Confusion. • Medi-Cal Beneficiaries are Treated Badly. • Late Enrollment Penalty for Life • Retirees with Current Drug Coverage – Beware! • The Donut Hole.

15. More Egregious… • No negotiating for best prices! • People are supposed to have choices… but they can’t be informed consumers • The plans get to change prices, formularies and deductibles at any time, but you don’t have the same options.

16. How it Works • Monthly Premium: $5.31 to $66.00 (Cal.) • Deductible: $250 per year • Co-payment: $500 max. up to $2,250 • Donut Hole: no coverage from $2,250 to $5100. Why? How will you know? • You get nothing but pay premiums anyway. • Catastrophic: after $5,100, covers 95% of drug costs. • Co-pays: $ $2 - $5 for each prescription

17. Don’t Blame the Pharmacist! • Pharmacists are on the frontlines: paying co-pays other costs. • Many of them are working hand-in- hand with the rest of us advocates.

18. Low Income Subsidy – The Basics • Those with incomes OVER this level and UNDER 150% of poverty level are eligible for low income subsidy but must apply through Social Security • Single – up to $1197 monthly • Couple – up to $1,604 monthly • Assets tests vary • First, you must apply for the subsidy, then you must enroll in a Part D Plan.

19. What did the Governor just do? • Authorized the State to pay for medications for some people who are on both Medicaid and Medicare • Was recently extended till May, and we’re hopeful for more extensions. • Great, but this problem isn’t going away!

20. Go here: http://www.assembly.ca.gov/committee_hearings/ or look it up in the phonebook Who’s your State Legislator?

21. Where You Can Go For Help • Health Insurance Counseling and Advocacy Program (HICAP): Call 1-800-434-0222 to reach your local HICAP or go to www.calmedicare.org. • Social Security: 1-800-772-1213 or go to www.ssa.gov. • Center for Medicare and Medicaid Services (CMS): Call 1-800-MEDICARE or go to www.medicare.gov. • CARA Part D Toolkit at www.retiredamericans.org Remember, most other sources of information are trying to sell you something

22. Enrollment = Chaos + Confusion • Enrollment is being pushed too quickly • Enrollment decisions are too complex • Too few resources are available to help consumers • Too little information is available in multiple languages and in formats easy for consumers to understand.

23. America Can Do Better After all that you’ve heard, what do YOU think… Will Medicare Part D reduce cost, improve access, and increase your ability to live a healthy life?

24. We Get By with a Little Help from Our Friends… • CARA (Alliance for Retired Americans)http://www.californiaalliance.org/default.asp • OWL (Older Women's League), Californiahttp://www.owl-national.org/ • Health Access Californiahttp://www.health-access.org/ • Congress of California Seniorshttp://www.seniors.org/ • Pharmacists Planning Services, Inc.http://www.ppsinc.org/ • California Pharmacists Association • http://www.cpha.com/AM/Template.cfm?Section=CPhA_Home • This presentation made possible by a grant from The California Wellness Foundation.

25. Together We Can Get A Real Prescription Drug Benefit Here are at least 4 Ways you can help. • Circulate & advocate • Educate • Tell your stories • Organize & mobilize

26. At the national level… CIRCULATE & ADVOCATE • Tell people about the problems with Part D and urge them to join the fight for a Real Drug Plan. • Join Gray Panthers and participate in meetings in your area. Call 916 332-5980 for the network in your area or to start a new one. • Organize to hold your representative accountable for real relief from high drug costs • Support HR 3861, the Medicare Informed Choice Act (Stark, Schakowsky) to extend the deadline • Support HR 752 (Stark, Berry) the Medicare Prescription Drug Savings and Choice Act, to create a uniform drug benefit in Medicare and require that Medicare negotiate for the best possible prices. 

27. Call Your Congressional Representatives • Dial the House & Senate switchboard • 1-202-224-3121 • Ask the operator for the first representative you want to reach • When connected: “Hello, I live in your district and I’m calling to ask you to: • Support HR 3861, the Medicare Informed Choice Act to extend the enrollment period and protect against bad choices. • Support HR 752, the Medicare Prescription Drug Savings and Choice Act, to create a uniform drug benefit in Medicare and require Medicare negotiate for the best prices • Reconsider & replace Medicare Part D with real reform that saves Medicare and provides relief from high drug prices.”

28. Educate Be part of a team to follow-up on today’s presentation. • Take what you’ve learned today back to other groups you’re involved with • Let us know if people are interested in further presentations (call (916) 921-5008) • Write a “Letter to the Editor” about the pain and confusion Medicare Part D is causing

29. Let’s Change our Language (Lakoff-ian Stuff) • Don’t blame Medicare, blame privatization! • Don’t talk of “enrolling” in a program, talk about buying insurance. • HSA’s: they’re not savings accounts; they’re High Deductible private insurance plans • Remember, health care is a value. Talk it up!

30. Tell Your Story (or help your friends….) Share your experiences and those of people you know • Tell your story today! • Collect stories from others tomorrow • Host a local meeting to get the press to cover the “dangerous side” of Part D.

31. Use Our Form if You’d Like… …or you can just use any old paper. We’d love to have people who are willing to testify, but we’ll protect your anonymity if you wish. We know that real stories are more effective than statistics in the advocacy process.

32. At the state level…Organize & mobilize • Participate in state hearings on Medicare Part D • Coordinate legislative visits in your area.

33. Reach Out To Potential Allies • Gray Panther member groups • Local senior and disability advocacy groups • Pharmacists and their organizations • Non-profit housing providers to seniors and persons with disabilities • Nursing Homes & Residential Care Facilities • Legal Services Programs • Paid and family care givers

34. Gray Panthers California/Sacramento P.O. Box 19438, Sacramento, CA 95819 For more information contactJoan B. Lee, Chairperson (916) 332-5980Email: joanblee78@lanset.comWebsite: http://www.gpcal.org/ Meetings: Steering Committee, 4th Tuesday of the month, 1-3Monthly Meetings: 2nd Tuesday of the month, 1-3 Hart Senior Center, 915 27th Street, Sacramento, CA 95816 Medicare Part D Project Margie Metzler 1121 Wayland Avenue Sacramento, CA 916-921-5008 margiemetz@hotmail.com Website: www.gpcal.org Contact us!

35. Are we laughing yet?