How can a Medicare prescription drug benefit be designed to ensure adequate coverage for individuals with multiple chronic conditions? Because of its expected drug costs, this particular population is a challenge to insure through private market approaches. Federal regulations and subsidies to maintain affordable premiums and costsharing will be needed to ensure access to coverage. Other consumer protections, such as benefit and plan stability requirements, would also be needed for people with multiple conditions and complex drug regimens. This brief examines how selected issues in designing a drug benefit affect people with chronic conditions and disabilities, using the House and Senate bills passed in June 2003 as examples.