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Letter to the Hon. Paul Ryan, Speaker of the House, the Hon. Kevin McCarthy, House Majority Leader, the Hon. Steve Scalise, House Majority Whip - Repair and Protect Medicare Part D

Letter

By: Billy Long, Sam Graves, Vicky Hartzler, Blaine Luetkemeyer, Ann Wagner, Tom Emmer, Dave Trott, Paul Mitchell, Mike Bishop, Tim Walberg, Fred Upton, John Moolenaar, Bill Huizenga, Jack Bergman, Andy Harris, Garret Graves, Ralph Abraham, Mike Johnson, Hal Rogers, Brett Guthrie, James Comer, Jr., Ron Estes, Kevin Yoder, Lynn Jenkins, Roger Marshall, Larry Bucshon, Luke Messer, Susan Brooks, Todd Rokita, Jim Banks, Adam Kinzinger, John Shimkus, Randy Hultgren, Rodney Davis, Mike Bost, Mike Simpson, Steve King, David Young, Rod Blum, Tom Graves, Jr., Rick Allen, Barry Loudermilk, Jody Hice, Austin Scott, Karen Handel, Drew Ferguson, Buddy Carter, Ileana Ros-Lehtinen, Brian Mast, Evan Jenkins, Alex Mooney, Mike Gallagher, Sean Duffy, Jim Sensenbrenner, Jr., Dan Newhouse, Jaime Herrera Beutler, Barbara Comstock, Dave Brat, Bob Goodlatte, Tom Garrett, Jr., Brian Babin, John Carter, Roger Williams, Kenny Marchant, Pete Olson, Lamar Smith, Bill Flores, Mac Thornberry, Kay Granger, Mike Conaway, Michael McCaul, Joe Barton, Jeb Hensarling, John Ratcliffe, Louie Gohmert, David Kustoff, Marsha Blackburn, Diane Black, Scott DesJarlais, Chuck Fleischmann, John Duncan, Jr., Phil Roe, Tom Rice, Ralph Norman, Jr., Trey Gowdy III, Jeff Duncan, Joe Wilson, Sr., Lloyd Smucker, Keith Rothfus, Lou Barletta, Bill Shuster, Ryan Costello, GT Thompson, Jr., Scott Perry, Mike Kelly, Jr., Steve Russell, Tom Cole, Steve Stivers, Mike Turner, Bob Gibbs, Bill Johnson, Bob Latta, Steve Chabot, Chris Collins, John Katko, Claudia Tenney, Elise Stefanik, Dan Donovan, Jr., Lee Zeldin, Mark Amodei, Steve Pearce, Rodney Frelinghuysen, Leonard Lance, Tom MacArthur, Adrian Smith, Kevin Cramer, Mark Meadows, Robert Pittenger, Richard Hudson, Jr., David Rouzer, Mark Walker, Virginia Foxx, George Holding, Greg Gianforte, Trent Kelly, Jason Smith, Tom Rooney, Dennis Ross, Bill Posey, Ron DeSantis, John Rutherford, Ted Yoho, Neal Dunn, Matt Gaetz, Michael Coffman, Doug Lamborn, Ken Buck, Mimi Walters, Ken Calvert, Ed Royce, Steve Knight, David Valadao, Paul Cook, Tom McClintock, Doug LaMalfa, Debbie Lesko, Paul Gosar, Martha McSally, Bruce Westerman, Rick Crawford, Robert Aderholt, Mike Rogers, Martha Roby, Bradley Byrne, John Culberson
Date: June 8, 2018

Dear Speaker Ryan, Leader McCarthy and Whip Scalise,

We write to support the extraordinary efforts you have made to fix a CBO scoring error from the Bipartisan Budget Act (BBA) and to protect seniors from a looming Medicare Part D catastrophic cap increase. We support your continued work on these issues and your efforts to attach a fix to an upcoming vehicle.

The scoring error occurred in an estimate of a BBA policy change that undervalued the federal savings attributed to an increase in the discount manufacturers are required to provide in the Part D "coverage gap." The BBA policy change increased the manufacturer discount (from 50% to 70%) and simultaneously reduced the contribution plans were scheduled to provide to help close the Part D donut hole (from 25% to 5% of costs).

The Centers for Medicaid and Medicare Services (CMS) recently expressed their concern about this change in the Final Part D Call Letter stating, "we have significant concerns about the impact these changes will have on drug costs under Part D in 2019 and future years…"1

Congress should fairly rebalance the policy in the coverage gap so that Medicare Part D continues to contain appropriate incentives to help control costs and the policy matches the federal savings originally intended in BBA. Correcting the discount policy will ensure that Part D remains a robust, market‐based program.

The second issue requires a change to ensure Medicare seniors are protected from an almost $1,500 increase to the Medicare Part D catastrophic attachment point. This increase will occur January 1, 2020, if Congress does not act. This looming hike is, unfortunately, a result of an Affordable Care Act (ACA) gimmick, but one that has real consequences for seniors, many of whom are very sick and on a fixed income. The ACA artificially slowed the rate of growth in the catastrophic coverage limit from 2014 to 2019, allowing more people to enter the catastrophic phase of the benefit where the government shoulders the vast majority of the costs. This change, in addition to other Part D changes under the ACA, has resulted in increased expenditures for the federal government and taxpayers.

We believe Congress can address the impact of the ACA gimmick and responsibly phase in the correction. This will limit the impact to the federal budget while simultaneously ensuring seniors are not exposed to such massive increases.

Congress should act quickly so that Medicare Part D stays on a more responsible path and seniors have longterm predictability. We are prepared to work with you and would support the Committees of jurisdiction's inclusion of policies to correct the BBA error and address the impact of the scheduled catastrophic increase in legislative vehicles being considered for the House floor.

Sincerely,


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