The Elephant in the Florida 22nd: Medicare Prescription Benefit

By Anushka Asthana
Washington Post Staff Writer
Sunday, October 1, 2006

HOLLYWOOD, Fla. -- Betty Priscak has voted for veteran Rep. E. Clay Shaw Jr. (R-Fla.) in every election he has been in, but now she thinks it is time for a change. Priscak, a 74-year-old in increasingly poor health, plans to vote for Ron Klein, Shaw's Democratic challenger, in November.

Why? She is upset with the Medicare prescription drug program passed by the Republicans in 2003. She calls it "devastating."

The initial uproar over the program's complexity died down once many seniors had signed up, but now Priscak and millions of other older Americans are confronting an interruption in their drug coverage that will require them to pay the full cost of their prescriptions -- or go without. Priscak came up against the coverage gap, known as the "doughnut hole," in May, and it was months before the drug coverage kicked back in.

If it had not been for financial assistance from her partner, she said, she would not have been able to meet the thousands of dollars of uncovered drug costs. "If you think I dare vote for a Republican, you have another thought coming," she said.

Priscak is not alone. According to the consulting firm Price Waterhouse Coopers LLC, 3.4 million seniors will fall into the doughnut hole this year.

The doughnut hole ends federal payments for a person's drug purchases once an annual spending limit is reached, resuming them only after the beneficiary has spent thousands of dollars out-of-pocket. It was one of the most contentious elements of the 2003 legislation that created the drug benefit, which was championed by the Bush administration and congressional Republicans.

Shaw's district, which stretches from West Palm Beach to Fort Lauderdale, has one of the highest concentrations of Medicare recipients in the country. Tens of thousands of residents have signed up for the prescription drug program, known as Part D. Democrats have long hoped to tap into voter dissatisfaction with the program, thinking it could affect some congressional races.

"When folks show up at the pharmacy and get hit with paying 100 percent of their drug costs, while continuing to pay 100 percent of their premiums, they become concerned," said Klein, a state senator. He said his main objection to the program is that it does not allow the federal government to negotiate drug prices to bring down costs -- a suggestion that pharmaceutical and insurance companies successfully fought.

But as the election draws closer, polls suggest that the GOP-backed program may not win as many votes for Democrats as they had thought. A Washington Post poll in April found that, among seniors, 50 percent said they approved of the drug program and 41 percent disapproved. Most respondents at that time said it would make no difference to them whether a candidate for Congress had voted for or against the drug program.

"Seniors are saving on average $1,100 a year in Florida; monthly premiums are $24," said Ed Patru, a spokesman for the National Republican Congressional Committee. "At the beginning of the year, the Democrats were politically invested in the failure of the program. Now there is overwhelming approval."

In one of Shaw's campaign offices, a converted diner in Fort Lauderdale, the congressman said seniors are better off under the program . "It's like the big lie. If you tell it enough, people begin to believe it," Shaw said of the criticism. "They are trying to convince people it was a windfall for the drug companies. It's not."

Shaw credits the plan with creating the competition that led Wal-Mart and Target to decide to discount their generic prescription drugs.

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