Hargis Points to Ongoing Challenges with Medicare Part D

By Lisa Boylan
Managing Editor, EpilepsyUSA
Posted: September 28, 2006

Landmark legislation, such as the Medicare Modernization Act, is ideally intended to benefit Americans by revising outmoded policies and instituting easily accessible programs that yield benefits to the broadest portion of the population. Change, however, is seldom easy.

Foundation president and chief executive officer Eric Hargis addressed some of the challenges evident in the implementation of Medicare Part D at a congressional briefing organized by the National Health Council, an umbrella health care advocacy group, on September 26.

Hargis first acknowledged the benefits of Medicare Part D, notably the access millions of older Americans have to prescription drug coverage. However, he also talked about the impact the legislation has had on Americans with disabilities that have the greatest health needs and the lowest incomes.

He gave an example of a couple—both of whom have epilepsy—from New York who are dually eligible for Medicare and Medicaid. Before the Medicare Drug Benefit, their drugs were 100% covered under New York State Medicaid. Under the new federal plan, their costs escalated well beyond their means. The woman, Patricia, tapered off her anti-convulsants in an effort to save money, which resulted in a break-through seizure that left her hospitalized for 2 days.

Hargis remarked that the Council does not "believe that Congress intended to force people to make choices between food and life-saving medications." He said the Council recommends "more one-on-one assistance for enrollment" and clearer explanations of coverage gaps, co-pays and premiums. He also addressed the problematic exclusions of benzodiazepines and barbiturates, which he cited as "particularly devastating for people with epilepsy, cancer, Alzheimer's or other mental health conditions."

During his presentation, Hargis introduced Dale Todd, a father from Cedar Rapids, Iowa. Todd stood, as the audience applauded, and proudly displayed a snapshot of his 7-year-old son Adam, who has epilepsy and continues to struggle with uncontrolled seizures.

Dale Todd (left) and
Senator Charles Grassley (IA)
discuss Medicare Part D implementation

Prior to the briefing, Foundation government affairs staff accompanied Todd on visits to Senate offices. Todd spontaneously ran into Senator Grassley, chairman of the Senate Finance Committee, in the corridor. Grassley invited him into his office where they chatted briefly. Todd said, "It helped put a personal face on the message that we're trying to get through to him, and I think he was receptive." He also met with Senator Harkin, whom he described as "a true champion and advocate of children and people with special needs."

Eric Hargis commented on the effectiveness of telling a personal story to legislators. He said, "Most people who come to Washington—who are elected—do so because they want to help people. They want to make a difference; they do care."

In the waning days of the 109^th Congress, Hargis said he thought the briefing was positive. He said, "At least what we did was lay a foundation for us to come back to Congress and reintroduce it."