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Thank you for contacting me regarding the Prescription Drug and Medicare Improvement Act of 2003 (S.1). I appreciate hearing from you on this important issue. As you know, Senator Frist introduced the Prescription Drug and Medicare Improvement Act on June 11, 2003. When this bill came to a vote before the Senate on June 27, 2003, it passed, with my support, by a vote of 76 to 21. The bill was not perfect, but I voted for it because I believed it was a good first step toward providing seniors with access to affordable prescription drugs. In addition, I knew that I would be able to work toward improving the bill during conference committee negotiations. This legislation creates a voluntary prescription drug benefit for Medicare beneficiaries. Under S. 1, beneficiaries would be required to pay a monthly premium of approximately $35 and an annual deductible of $275. After this deductible is met, the government would pay for half of a person's annual drug expenses until those expenses hit $4,500. The beneficiary would be responsible for all of his or her drug costs until the expenses reach $5,800. After that point, the government would pay 90 percent of the beneficiary costs. Prior to the implementation of this program in 2006, Medicare beneficiaries would be able to purchase discount drug cards and obtain savings when drugs are purchased at a retail establishment. Although I was able to improve the bill before it passed the Senate, there's more work to do. Before the bill takes effect in 2006, I think we should add provisions to close the coverage gap for seniors with particularly high prescription drug expenses, and to ensure that seniors who live in rural areas have the same choices as those who live in urban areas. You may also be pleased to know that I successfully offered an amendment to provide greater cost savings to seniors by requiring pharmacy benefit managers (PBMs), the companies that control the purchase of most prescription drugs, to disclose their financial arrangements to antitrust regulators in order to make certain that there is no price fixing occurring between PBMs and drug companies and to make sure that PBMs are doing the best job possible of passing negotiated savings on to seniors. On that same day the Senate passed S.1, the House of Representatives passed its version of this bill (H.1) by a vote of 216 to 215. Since this time, members of both chambers having been negotiating the differences between these bills in a conference committee. I have worked with my colleagues extensively on a number of issues during these negotiations. I have fought to provide an increase in physician reimbursement rates, worked to protect retiree benefits, strived to ensure that cancer drugs and cancer care services are appropriately reimbursed, and have labored to ensure that the amendment I offered on PBMs is included in the final bill. As you may already know, the conference committee recently reached a tentative compromise on this legislation. I have not yet received a copy of this proposal and am currently relying on media reports for information relating to what the compromise bill actually includes. It is my understanding, however, that there are significant differences between this proposal and the bill I voted for in June. Please be assured that I will keep your views in mind as I continue to work with my colleagues in Congress to strengthen this prescription drug benefit for all Medicare beneficiaries. Again, thank you for contacting me. Please do not hesitate to contact me if I may be of any assistance in the future. Sincerely, Maria Cantwell United States Senator
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