Keeping watch: Senator Charles Grassley champions choices provided by competitive plans

According to Senator Charles (Chuck) Grassley, the Medicare Modernization Act of 2003 (MMA) has worked out better than expected, but he still keeps a close watch to ensure healthcare dollars are well spent. As chairman of the Senate Finance Committee, Grassley has tremendous clout in Washington. His committee is responsible for tax policy, Social Security, Medicare and Medicaid, which made him a central player in developing and enacting MMA.

In addition to passing laws, Grassley says it's his job to keep a close watch on how federal agencies carry out Congressional mandates. If a department or government contractor fails to implement approved programs or to meet standards, the senator says he "sinks his teeth in" and doesn't let go until the situation is remedied.

Better than expected

Some prescription drug plans are providing added coverage, particularly options that fill in the "donut hole" in Part D. Providing coverage through the gap would have cost $400 billion, which, Grassley explains, would have doubled the cost of the program. "Now we have plans that don't have donut holes, and we didn't even force it on them," the senator notes.

Grassley is particularly pleased by a significant increase in health plans serving seniors in his home state. "We wanted rural America to have the same competition and choice as urban America in the case of Medicare Advantage. And now there are 44 plans in Iowa, so we don't have to worry about having choice for our people."

No penalties

Implementing the MMA has not been all smiles. Grassley is furious about what he calls a "partisan assault unleashed by Democratic leaders" to convince beneficiaries that it was too difficult to sign up for Part D and not worth the effort. Millions of Americans who enrolled in prescription drug plans (PDPs) and Medicare Advantage drug plans (MA-PDs), however, are benefiting from needed drug coverage, despite the campaign to "sink Medicare Rx," he says.

Grassley also wants to remedy inequities that he feels are hurting small-town pharmacies that provide access to medicines in rural areas. Independent pharmacists have complained that PDPs do not reimburse them in a timely manner and are shifting patients to mail-order pharmacy programs. Grassley is part of a large group of senators urging CMS to ensure policies for local pharmacies. In a letter to CMS Administrator Mark McClellan, MD, in July, the senators pointed to PDP delays in updating listed prices and other actions that make it difficult for pharmacies to participate in Part D.