Congressman Henry Cuellar (TX-28) announced today Congressional District 28 is directly benefiting from health care reform by paying less for prescription drugs – more than 2,169 Medicare beneficiaries in the ‘donut hole’ or coverage gap saved $1,268,560, after the enactment of the Affordable Care Act. The average discount amount per Medicare beneficiary in Texas is $594.38

“For too long, those having to purchase prescription drugs using their Medicare Part D benefits were paying high out-of-pocket costs for medication they depend on once they entered in the ‘donut hole’,” Congressman Cuellar said. “My constituents have saved $1.2 million in prescription drug costs due to the 50% discount on their medications – this is great news for those who used to bear the brunt of paying for 100% of the costs. Health care reform continues to directly improve the lives of the American people by affording them health care coverage.”

“One year after the law was enacted we see the important cost-saving measures that are helping Medicare beneficiaries. In the near future, as new provisions of the law take effect, the American people will have access to more health care at a cost they can afford,” Cuellar said.

Below is a breakdown of the number of Medicare beneficiaries that have received a discount in counties in the 28th District of Texas:

Total Year-to-Date Gap Discount by County through May 31, 2011

County Name   Number of Beneficiaries     Total Discount
Atascosa   34   $18,704.30
Bexar (partial)   1620   $949,646.83
Guadalupe   88   $49,383.48
Hidalgo (partial)   301   $178,299.22
Starr   18   $14,532.71
Webb   67   $33,838.58
Wilson   41   $24,155.38
TOTALS   2169   $1,268,560.50
Source: Centers for Medicare & Medicaid Services, May 31, 2011

Since January 2011, nearly 500,000 people with Medicare Part D who reached the gap in coverage know as the “donut hole” received an automatic 50 percent discount on their brand name prescription drugs nationwide. These beneficiaries saved a total of $260,534,102, or an average savings of $545 per beneficiary. Texans have saved over $16 million, as a result of the discount on prescription drugs purchased within the Affordable Care Act, now law.

Background:

The Affordable Care Act was signed into law on March 23, 2010, and made several changes to reduce out-of-pocket costs, including Medicare Part D Improvements for Prescription Drug Plans.

Referred to as “donut hole,” the coverage gap is a concern to seniors and disabled who are enrolled under the Part D prescription drug plan. Once beneficiaries have spent the amount of coverage limit for their prescription drugs, they fall in the donut hole and (prior to the enactment of the Affordable Care Act) had to pay full costs of prescription drugs.

Under the Affordable Care Act, since January 2011, Medicare Part D improvements allow people to receive a 50% discount on prescription drugs purchased when they fall in the “donut hole” or gap. By 2020, rather than paying 100% of costs, the coverage gap will close and the beneficiary’s responsibility will be 25% of costs.