Pelavin: Not only will the House Medicare bill fail to fulfill the needs of America's elderly and disabled citizens, it will undermine the program altogether.
Contact:Alexis Rice or Becca Nagorsky 202-387-2800
WASHINGTON, June 25, 2003 - In a letter today to the House of Representatives, Mark J. Pelavin, Associate Director of the Religious Action Center of Reform Judaism (RAC), urged Representatives to oppose the Prescription Drug and Medicare Modernization Act of 2003 (H.R. 2473), noting, "All seniors deserve better than the substandard coverage offered by H.R. 2473."
The complete letter follows:
On behalf of the Union of American Hebrew Congregations (UAHC), whose over 900 congregations encompass 1.5 million Reform Jews, and the Central Conference of American Rabbis (CCAR), representing 1800 Reform rabbis, I write to express our opposition to the Prescription Drug and Medicare Modernization Act of 2003 (H.R. 2473). Because of the high average median age of the Jewish population, this issue disproportionately affects the Jewish community. All seniors deserve better than the substandard coverage offered by H.R. 2473.
According to Jewish tradition, providing health care is not just an obligation of the doctor, but for society as well. It is for this reason that health care is listed first by Maimonides, a prominent 12th century Jewish physician and scholar, on his list of the ten most important communal services that had to be offered by a city to its residents. During the long history of the self-governing Jewish community, almost all such communities set up societies to ensure that all their citizens had access to health care.
The very existence of the Medicare program is recognition of society's continued obligation to provide health care services. Prescription medications in particular are a vital part of modern medical care and it is, therefore, crucial that Medicare include prescription drug coverage so as to continue to fulfill its mandate of providing reliable and comprehensive health benefits to America's elderly and disabled citizens.
We have several major concerns with H.R. 2473. Not only does the bill force beneficiaries to access Medicare benefits through private insurance plans, it does not provide comprehensive coverage, and it "means tests" Medicare, thereby altering the fundamental character of Medicare as a universal benefit.
More specifically, the bill would:
- Compel beneficiaries to join private HMO and PPO plans to access their Medicare benefits. Under H.R. 2473, a prescription drug benefit would be available through traditional fee-for-service Medicare, but even this option, which would maintain the structure of traditional Medicare, would be offered through a private stand-alone drug insurance plan. H.R. 2473 contains no governmentally administered fall-back option so that if no private plans choose to enter an area to offer coverage, beneficiaries must either remain in traditional Medicare and not receive a drug benefit, or join a private plan to get drug coverage. In the past, private plans in Medicare have been notoriously unreliable, frequently pulling out of areas and leaving seniors and people with disabilities without health care.
- Leave many beneficiaries with a significant amount of drug costs to bear on their own by including a very large coverage gap, often referred to as a "doughnut hole." Medicare would pay 80 percent of drug costs between $275 and $2,000 of out-of-pocket spending. Beyond that, Medicare would not subsidize further costs until a senior paid $4,900 in out-of-pocket costs. For low-income seniors and people with disabilities, this is a devastating gap that will force many them to leave prescriptions unfilled.
- Force seniors and people with disabilities to pay more to stay in traditional Medicare. After 2010, traditional Medicare and private plans would have to start setting premiums according to their spending. The so-called "competitive bidding" system in the bill would create a very unfair competition among private plans-which "cherry-pick" and enroll the youngest, healthiest and least expensive seniors-versus the traditional Medicare program that serves sick and healthy alike. As a result, the costs of the traditional Medicare program will rise, and seniors will be forced out of traditional Medicare. Those unable to afford the cost of staying in traditional Medicare would be forced to enroll in a PPO or HMO.
- Undermine the universality of the Medicare system. Every American pays into the system, and every American can access the benefit when they become eligible. H.R. 2473 "means tests" Medicare by forcing seniors making more than $60,000 a year to assume more of their own costs. While it seems to make sense that those who are able to pay for more of their own medications should do so, this change to the fundamental Medicare philosophy would be tremendously damaging. Medicare was conceived as and should remain a universal program.
Not only will the House Medicare bill fail to fulfill the needs of America's elderly and disabled citizens, it will undermine the program altogether. I urge you to oppose this legislation and instead advocate for a meaningful, affordable, and guaranteed prescription drug benefit in Medicare.
Mark J. Pelavin
Religious Action Center of Reform Judaism
The Religious Action Center of Reform Judaism is the Washington office of the Union of American Hebrew Congregations (UAHC) , whose over 900 congregations across North America encompass 1.5 million Reform Jews , and the Central Conference of American Rabbis(CCAR) whose membership includes over 1800 Reform rabbis .