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Tuesday, July 18, 2006

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It's 'Doughnut Hole Day'

A Krispy Kreme doughnut

Democrats today are highlighting Medicare's "Doughnut Hole" coverage gap, but there's disagreement over just how many people will actually fall into the hole. Helen Palmer reports.

A Krispy Kreme doughnut (Getty Images)

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TEXT OF STORY

TESS VIGELAND: A group of House Democrats has dubbed today "Doughnut Hole Day." Sounds like a tasty time to be on Capitol Hill, but the moniker refers to the temporary cutoff of Medicare recipients when their annual prescription drug costs reach a certain amount. Democrats say the average beneficiary will reach the cutoff today. But as Helen Palmer reports from the Health Desk at WGBH, there's little consensus on how many people the problem will swallow.


HELEN PALMER: The donut hole is meant to control government costs for the new Medicare Drug program.

Once seniors total drug costs reach $2,250, they must pay the next $2,850 out of pocket. Then the benefit kicks in again.
MARILYN MOON: We're talking about somewhere between four and eight million people who will have a period with no prescription drug coverage even though they're paying premiums.
Marilyn Moon of the American Institutes for Research. The non-profit Kaiser Family Foundation reckons seven million seniors will face the gap before year's end.

But the Healthcare Leadership Council, an industry group, says less than three and a half million will face the coverage gap. The Council's Michael Freeman:
MICHAEL FREEMAN: The majority of those in the coverage gap had no drug coverage at all before the Medicare Drug benefit was enacted.
Freemen says even with the costs they face now, seniors will be about $2,000 better off than before the benefit kicked in.

In Boston, I'm Helen Palmer for Marketplace.

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