Medicare Part D Update — Lessons Learned and Unfinished Business

Abstract

Since 2006, more than 40 million elderly and disabled people have had the opportunity to enroll in a Medicare Part D prescription-drug plan, as established under the Medicare Modernization Act (MMA) of 2003. Members of Congress, deeply divided by policy and ideological differences, debated several features of the proposed legislation before its passage.¹ Issues that received particular scrutiny were the unprecedented way that the benefit would be delivered (exclusively through private plans) and its design, featuring an unusual gap in coverage (sometimes called the “doughnut hole”). Policymakers questioned whether insurance companies would be willing to offer stand-alone drug plans, how many beneficiaries would choose to enroll in a voluntary program, and how the program would affect drug prices and overall Medicare spending.²