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Medicare Drug Benefit, Stem Cell Research Among Kennedy's Priorities for HELP

By Mary Agnes Carey, CQ HealthBeat Associate Editor

November 16, 2006 -- Filling in the Medicare drug benefit's "doughnut hole," lifting federal curbs on stem cell research, and reauthorizing a federal program that helps provide health coverage to children will all be priorities next year for the Senate Health, Education, Labor and Pensions (HELP) Committee, Sen. Edward M. Kennedy said Thursday.

Kennedy, a Massachusetts Democrat who will assume chairmanship of the HELP panel in the 110th Congress, laid out an ambitious agenda for the panel, including raising the minimum wage and reducing college costs. But health care will be a primary focus as well for Kennedy, who has long been a key player in health care policy.

In both a Senate floor speech and a news conference afterwards, Kennedy's health agenda touched on several themes, including using information technology to reduce health care costs while improving the quality of care delivered, finding ways to cover the more than 40 million uninsured Americans, and giving the secretary of the Department of Health and Human Services the ability to negotiate drug prices on behalf of Medicare beneficiaries. Kennedy said he also was "hopeful" that Congress would pass "mental health parity" legislation that would require insurers to offer the same coverage for mental health illness as they do for physical ailments.

Kennedy also said he will work to lift current federal funding restrictions on stem cell research despite President Bush's veto in July of legislation that would have accomplished that goal. "We will be back again and again next year until we succeed in overturning the restrictions on stem cell research that hinder the search for new cures . . .," Kennedy said.

Concerning the Medicare prescription drug benefit, Kennedy said the HELP panel would work with the Finance Committee to make the benefit "affordable and eliminate the doughnut hole and other inefficiencies." The doughnut hole refers to a coverage gap in some Medicare drug plans that requires beneficiaries to pay for drugs out of pocket when their costs in any given year total between $2,250 and $5,100.

Reexamining how federal funding of the Medicare drug benefit is distributed—in particular $44 billion in " subsidies" for managed care plans offering coverage to Medicare beneficiaries—might help produce funds to close the coverage gap, Kennedy said.

"There's a lot of money that's rattling around out there and the question is who's going to get it, and we're going to try to help those who should have it," Kennedy said. He also told reporters that the benefit is "enormously confusing" for beneficiaries.

If you have fewer choices, people take them and use them and benefit from them and work much more than if you have many different choices," Kennedy said, adding that Medicare beneficiaries in Massachusetts have 45 different plans to pick from if they want to enroll in the drug benefit, with each plan featuring different copays and deductibles. "It's confusing, it's upsetting, and it's enormously inefficient and costly," he said.

As HELP chairman, Kennedy pledged to continue working closely with the committee's outgoing leader, Republican Michael B. Enzi of Wyoming. "The gavel may change hands, but our partnership will not," Kennedy said.

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