Sign On and Preserve the Medicare Part D Program

Dear Congressman/Senator:

Legitimate concerns over an exploding federal budget deficit and looming “fiscal cliff” have prompted some Members of Congress and the Obama Administration to propose Medicaid style rebates for the dual eligible and Medicare low income subsidy (LIS) populations, which together account for 56 percent of Medicare prescription drug spending. This proposal would require manufacturers of brand name drugs to pay the federal government a rebate on drugs purchased by enrollees in the LIS program. On behalf of the undersigned organizations, we are writing to register our strong opposition to mandatory rebates on prescription drugs in Part D.

The signatories of this letter are a broad based coalition representing providers, consumers, patients, insurers, and employers. We recognize the urgent need for Congress to reduce the nation’s debt and spur economic growth. We believe, however, that achieving real savings requires reducing costs, not shifting them onto others. A Part D mandatory rebate would fail this test.

Specifically, a Part D rebate could:

Increase premiums. Economic studies have estimated that Part D premiums for most Medicare beneficiaries could increase by 20 to 40 percent under the rebate approach. Half of Medicare beneficiaries had household incomes below $21,183 in 2010. Half of those aged 85 and older had incomes under $18,000. Medicare populations cannot afford these rebate-driven increases in their prescription drug plans.

Shift as much as $112 billion in costs onto employers, Medicaid, and the 79 percent of Medicare beneficiaries who do not participate in LIS. The proposal would expand Medicaid-style rebates to roughly 40 percent of Medicare Part D beneficiaries who account for more than half of Part D spending. At the same time, Medicaid populations will also grow dramatically as the result of the Affordable Care Act; 18 million is the forecast. The combination of $112 billion in estimated savings from the proposal, and the growing rebates created by an expanded Medicaid population will conspire to increase drug prices and costs. Economic studies show these costs could be passed on to employers, Medicaid and beneficiaries.

Jeopardize savings and patient adherence to drugs. Less access to affordable prescriptions means patients may not take the drugs they need as prescribed. Because the availability of affordable drug coverage is achieving savings of about $1,200 annually per beneficiary in reduced hospital and skilled nursing facility costs, proposals that increase drug costs may lead to higher costs in more expensive settings. In addition to the human toll, Medicare could incur tens of billions of dollars annually in avoidable complications and hospital admissions.

Weaken the incentives that have helped dramatically reduce the cost of prescription drugs for seniors. This year the average Part D premium came in at less than half the Medicare Trustees’ 2004 projection, and total costs for the program were 43 percent lower than CBO’s forecast that same year. Earlier this year, the CMS Administrator at the time said Part D is “a competitive market and we’re seeing the effect of good competition among Part D plans take its effect”.

In a Medicare system that is fraught with inefficiencies, Part D has set the standard for delivering better value at a lower cost. As health costs have increased elsewhere, the average Part D premium, thanks largely to competitive bidding, has held steady the past three years. An astounding 90 percent of enrollees are satisfied with their coverage. This argues for exercising caution in fundamentally changing incentives in a program that clearly has demonstrated success on so many fronts.

We strongly urge Congress to reject any proposals that would undermine the current program’s success in holding down premiums. A Part D mandatory rebate is a poorly informed, ill-conceived policy that poses serious risks to the health and well-being of millions of seniors, veterans and persons with disabilities.

We look forward to working with Congress to help strengthen Medicare and to ensure that the program is stable, efficient and effective, and that it continues to maintain and improve the health of beneficiaries.

National Organizations

AIDS Institute
Allergy & Asthma Network
American Autoimmune Related Diseases Association
Asian & Pacific Islander American Health Forum
Association of Black Cardiologists
Blue Ribbon Advocacy Alliance
COPD Foundation
Council for Affordable Health Coverage
Ehlers-Danlos Syndrome Network C.A.R.E.S. Inc.
Genetic Alliance
Global Healthy Living Foundation
Healthcare Leadership Council
Healthy African American Families Phase II
Interamerican College of Physicians and Surgeons
International Institute For Human Empowerment, Inc.
Kidney Cancer Association
Latino Commission on AIDS
Licensed Professional Counselors Association
Men’s Health Network
National Alliance on Mental Illness
National Asian Pacific Center on Aging
National Association for Continence (NAFC)
National Association for Medical Direction of Respiratory Care
National Association of Health Underwriters
National Association of Manufacturers
National Association of Nutrition and Aging Services Programs
National Association of People with AIDS
National Black Nurses Association
National Council for Community Behavioral Healthcare
National Council on Asian Pacific Islander Physicians
National Hispanic Medical Association
National Medical Association
National Minority Quality Forum
National Taxpayers Union
Newborn Coalition
Pharmaceutical Industry Labor-Management Association (PILMA)
Small Business & Entrepreneurship Council
The International Autoimmune Arthritis Movement
The Latino Coalition
The National Grange
U.S. Chamber of Commerce
US Pain Foundation
Veterans Health Council
Women Against Prostate Cancer
ZERO – The End of Prostate Cancer

State Based Organizations

“It’s About Me” Breast Cancer Awareness Association, KS
1 in 9: The Long Island Breast Cancer Action Coalition, NY
4th Street Clinic, UT
A Partnership of Diabetics (A-POD), MN
Advanced Cancer Therapeutics, KY
Advocacy Center, Louisiana
Advocates for Responsible Care, GA
AIDS Alliance of Northwest Georgia
AIDS Outreach Montana
AIDS Resource Center Ohio
Alabama Council of Community Mental Health Boards
Alabama Lifespan Respite Resource Network
Alabama Silver Haired Legislature
Alder Health Services, PA
All of Life, UT
Alliance Community Services, UT
Alliance House of Utah
Alzheimer’s and Dementia Alliance of Wisconsin
Alzheimer’s Association – Montana Chapter
Alzheimer’s Association – San Antonio & South Texas
American Liver Foundation – Western PA
American Small Business, KY
Amigos por la Salud, FL
Angel Hospice, LA
Areawide Aging Agency, Inc., OK
Arthritis Association of Louisiana
Arthritis Topeka, KS
Associated Industries of Missouri
BayBio, CA
Bio District New Orleans, Louisiana
Bio Nebraska Life Sciences Association
BioForward, WI
BioHouston, TX
Birmingham Metro Diversity Coalition, AL
Blue Ribbon Advocacy Alliance, FL
Boat People SOS, AL
Brain Injury Association of Nebraska
Calcasieu Council on Aging, LA
California Black Health Network
California Healthcare Institute
California Senior Advocates League
Capital District African American Coalition on AIDS (CDAACA), NY
Center for Health Care Services, TX
Centro Civico of Amsterdam, Inc., NY
Centro de Mi Salud, LLC – Bilingual Behavior Health
Care Services, TX
Chez Hope, Louisiana
Cimarron Alliance, OK
Coalition of Texans with Disabilities
Colorado Gerontological Society
Combined Health Agencies, CA
Comfort Keepers of Greater Charleston, SC
Community Action Association of Alabama
Community Health Action Network
Community Health Charities Iowa
Community Health Charities of Florida
Community Health Charities of Nebraska
Community Health Charities of Wisconsin
Community Volunteers Association, Louisiana
Council on Aging of Greater Nashville, TN
Crohn’s and Colitis Foundation of America – Minnesota/Dakotas Chapter
Crohn’s & Colitis Foundation – Rocky Mountain Chapter
Crohn’s & Colitis Foundation of America, Iowa and Nebraska
Daughters of Charity Services of New Orleans
Des Moines WomenHeart ,IA
Diabetes Dayton, OH
Disabled Rights Action Committee, UT
Easter Seals of Massachusetts
Easter Seals UCP North Carolina
El Paso Diabetes Association
Elder Care Advocacy of Florida
ElderServe, KY
Embracing Latina Leadership Alliances (ELLAS), CA
Epilepsy Association of the Big Bend, FL
Epilepsy Foundation of East Tennessee
Epilepsy Foundation of Western Wisconsin
Family and Youth Counseling Agency, Louisiana
Federation of Protestant Welfare Agencies, NY
Filipino American Service Group, Inc. (FASGI), CA
Firehouse Ministries, Louisiana
First Step House, UT
FirstLight Senior Care, KY
Florida Hispanic Chamber of Commerce
Florida Transplant Survivors Coalition, Inc.
Friends of West End, AL
Georgia Bio
Georgia Commission on Women
Georgia Institute for Women
Georgia Osteoporosis Initiative
Greater Louisville Association of Health Underwriters, KL
Greater OK City Chamber of Commerce
Guardia Care, KY
Guiding Right, OK
H.E.A.L.S of the South, FL
Harlem United Community AIDS Center, NY
Harvey Citizens for Part D, LA
Health Access, Louisiana
Health Care Navigators, KY
Healthy African American Families Phase II, CA
Healthy Heritage Movement, CA
Hep C Connection, Colorado
Hispanic Interest Coalition of Alabama (HICA)
Hope House, LA
Houston Realty Business Coalition, TX
Illinois Biotechnology Industry Organization
Independent Medicine, Prof. LLC, SD
Indiana Health Industry Forum
Instructive Visiting Nurse Association (IVNA), VA
Interamerican College of Physicians & Surgeons, FL
Interdenominational Ministerial Alliance of Greater Mobile, AL
International Autoimmune Arthritis Movement (IAAM) , CA
Iowa Biotech Association
Iowa State Grange
Jefferson Council on Aging, Louisiana
Jennings, Louisiana Medicare Access
Jobkeeper Alliance, AL
Juvenile Diabetes Research Foundation of Utah
Kansas Healthcare Leadership Council
Kentucky Association of Health Underwriters
Kentucky BioAlliance
Kentucky BioProcessing
Kentucky Chamber of Commerce
Kentucky Senior Resources
KeyVive, UT
Lafayette Council on Aging, Louisiana
Latin American Chamber, UT
Latino Diabetes Association, CA
Leukemia & Lymphoma Society – Greater Los Angeles Chapter
Leukemia & Lymphoma Society Iowa and Nebraska
Leukemia and Lymphoma Society of San Diego
Life-Links Geriatric Care Management, TN
LifeScience Alley, MN
Louisiana Arthritis Association
Louisiana Black Health TV
Louisiana Blue Cross
Louisiana Health Access Network
Louisiana Medicare RX Access Network
Louisiana People’s Health
Louisiana SHIP
Louisiana Women’s Network
Louisiana for Part D
LRI National Coalition, NY
LSU Medical Center
Lupus Alliance of America, Long Island/Queens Affiliate
Lupus Alliance of America, NYST Affiliate
Lupus Alliance of America, Upstate NY Affiliate
Lupus Foundation of America, Iowa Chapter
Lupus Foundation of America, Texas Gulf Coast Chapter
Lupus Foundation of Florida, Inc.
Lupus Foundation of Genesee Valley NY, Inc.
Lupus Foundation of Mid and Northern New York
Lupus Foundation of Oregon
Lupus Foundation of Southern California
Lupus Foundation of Utah
Magic Valley NAMI, ID
Manufacture Alabama
Massachusetts Association for Mental Health
Massachusetts Biotechnology Council
Massachusetts Health Council
Medical Oncology Association of Southern California
MEDwheels, Inc., TX
Mended Hearts, Inc., OH
Mental Health America of Greater Tarrant County (TX)
Mental Health America of Middle Tennessee
Mental Health America of the Heartland, KS/MO
Mental Health Association in New York State, Inc.
Mental Health Association of Nebraska
Metacyte Labs, KY
Missouri Chamber of Commerce and Industry
Missouri Healthcare Leadership Council
MO Bio
Montana State Grange
Mount Carmel Health System, CA
Mountain Health and Community Services, CA
NAACP, Ogden Branch
NAMI – Mid-Carolina
NAMI – Nebraska
NAMI Florida
NAMI North Carolina
NAMI of Oklahoma
NAMI, Utah
National Association of Social Workers, NC
National Council of Negro Women: Southern California Area, View Park Section
National Health Foundation, CA
National Kidney Foundation serving Ohio
NC Action for Children
NC Biotechnology Center
NC Psychological Association
NC Bio
Neighborhood Health Association, OH
New Orleans Council on Aging
Norman Chamber of Commerce, OK
North Carolina AIDS Action Network
North Carolina Association of Health Underwriters
North Carolina Chamber
North Idaho AIDS Coalition
Northeast Kidney Foundation
Northern Utah Coalition
Ohio AIDS Coalition
Ohio Council for Home Care and Hospice
OK City Area Agency on Aging
Okie’s Pharmacy, TN
Oklahoma Association of Optometric Physicians
Old North State Medical Society, NC
Oncology & Hematology Institute, Louisiana
Oregon Bioscience Association
Oregon Chamber of Commerce
Other Options Food Pantry, OK
Ovarian Cancer Coalition of Greater California
Owensboro Medical Center, KY
Pacific Islander Chamber of Commerce, UT
Palmetto AIDS Life Support Services, SC
Parkinson’s Association of San Diego
Parkinson’s Partners, KY
Partners in Care Foundation
Partnership For A Drug Free NC
Patient Services Inc., VA
Pennsylvania Bio
Perennial Services Network, TN
Plaza Community Services, CA
Prairie Healthcare Advocacy, Inc., SD
Prescription Access Network of Stark County, Inc., OH
Prevent Blindness Iowa
Prevent Blindness Ohio
Project Success, UT
RAIN Oklahoma
Reels for Recovery, UT
Rio Grande Valley Diabetes Association, TX
Rio Grande Valley Partnership, TX
Rocky Mountain Stroke Center, CO
Rush to Live, IL
RxMed Pharmacy, TN
S.L.E. Lupus Foundation, NY
San Clemente Collaborative, CA
Scleroderma Foundation/Tri-State Chapter, NY
Senior Connections, The Capital Area Agency on Aging, VA
Sjögren’s Syndrome Foundation, NY
South Carolina HIV-AIDS Council
South Dakota Cares
Southeast Georgia Communities Project
Southhall Oubre Clinic, Louisiana
State Chamber of Oklahoma
Tech Council of Maryland
Teche Action Clinics, Louisiana
Tennessee Association of Health Underwriters
Terrebonne Council on Aging, Louisiana
Texas Association of Business
Texas Association of Manufacturers
Texas Bio Corridor Alliance
Texas BioAlliance
Texas Business Group on Health
Texas Conservative Coalition Research Institute
Texas Healthcare and Bioscience Institute
Texas Nurse Practitioners
Texas Oncology
Texas Research & Technology Foundation
Texas Senior Advocacy Coalition
The G.R.E.E.N. Foundation, CA
The Minority Health Institute, CA
The Patriots’ Project
The Virginia Hispanic Chamber of Commerce
The Wall Las Memorias Project, CA
TMJ Society of California
Transition House, OK
Twin Falls Senior Center, ID
United Cerebral Palsy of Alabama
Urban League of Portland, OR
Utah Advocates
Utah Black Chamber
Utah Developmental Disabilities Council
Utah Hispanic Chamber of Commerce
Utah Public Employees’ Association
Utah Support Advocates for Recovery Awareness
Vietnamese Social Services of Minnesota
Virginia Biotechnology Association
Virginia Chamber of Commerce
Virginia Rural Health Association
Visiting Nurses Association
Windows of Hope, Louisiana
Wisconsin Women’s Health Foundation
Wisdom of Wellness Project, GA
Women of Faith and Hope, Inc., PA
Women’s Health Access Project, Louisiana
Womens3D, LA
Wood River Valley NAMI, ID
Wound Care Clinic, GA
Wyoming Epilepsy Association

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  • Preserve Part D