Medicare Part D Coverage Gap Policy Process: Part 1
Toni S. Thompson
HCS 455:   Health Care Policy:   The Past and the Future
Instructor:   Daryl Anderson
University of Phoenix
February 8, 2011

Medicare Part D Coverage Gap Policy Process:   Part 1
      This paper will discuss the policy dealing with the Medicare Part D coverage gap and how it became a policy.   The three processes that will also be discussed are the formulation, legislative, and implementation process of this policy.    
The Policy
      President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010.   This policy made changes to Medicare Part D drug benefit that reduced enrollees’ out of pocket liability when they reach the coverage gap, known as the doughnut hole (Centers for Medicare and Medicaid Services, 2010).
The History
      The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 established Part D, to help Medicare beneficiaries pay for prescription drugs not covered (US Department of Health and Human Service, 2005).   Initially prescription drug discount cards on a voluntary basis and at limited cost were given to all Medicare enrollees, except those receiving Medicaid.   This temporary plan began in 2004 and phased out in 2006.   In 2006, Part D was provided by private insurance companies approved by the Center for Medicare and Medicaid Services.   This coverage was on a voluntary basis.   Premiums paid by Medicare enrollees were added (Centers for Medicare and Medicaid Services, 2010).
The Problem
      The elderly enrolled in Medicare Part D pay 58 percent more for the most commonly prescribed drugs than Americans who buy their medications through health plans administered by the Department of Veterans Affairs, which is another drug plan sponsored by the government.   The Medicare Part D benefits offered by private insurance companies operate with high administrative costs, sales expenses, and profits (Silverman,...