TCC Texas Conservative Coalition December 2, 2014 ‘The Honorable Jol Cornyn United States Senate ‘517 Hart Senate Office Bldg. ‘Washington, D.C. 20510 Dear Senator Cornyn: ‘The Medicare Part D prescription drug benefit plan has been a successful program by any measure. A decade has gone by since Part D's creation, and now 95 percent of Medicare beneficiaries receive ‘comprehensive drug coverage with which they are satisfied, Taxpayers have come out ahead as well. Part D's total costs and preniums have been consistently lower than projected. Analysis by the Congressional Budget Office shows that Part D has cost $349 billion (45%) less than initially projected. ‘This is 2 rare positive outcome from a government program, largely attributable to Part D's market- centered pricing mechanismsand its “non-interference” clause, which prohibits the government from interfering in private price negotiations between Medicare Part D plans, drug manufacturers, and pharmacies. Despite its success, Part D remains a target for those who do not like the idea of market-oriented reforms outperforming goveinment design, On January 10, 2014, the Centers for Medicare and ‘Medicaid Services (CMS) proposed a number of rule changes to Part D. The Texas Conservative Coalition was among a group of 200 organizations that came together to oppose the new rules. Those rules were not Implemented, but also not abandoned, and we expect CMS to try again Indeed, CMS Administrator Maryn Tanner suggested as much when—after tabling the plans following the receipt of close to 6,000 comments from public protesters—she stated that CMS would “engage in further... nput bafore advancing... the changes in these areas in future year.” Looking ahead to CMS's next attempt, itis important to remember what their proposals would do to Part Din terms of reducing choice and competition. First, the neve rules would limit bids thet plan ‘may offer in a particular reglen to two, one basic and one extended, effectively reducing choices and driving up costs for seniors. The rules would also undermine Part D's non-interference provision ‘hich has been so successful in prohibiting government price controls. Though the new rule would continue to prohibit iterferesce in negotiations between plans and manufacturers, it would begin to allow governmental interferance between plans and pharmacies. This would allow the federal {government to prohibit cost-sharing arrangements between plans and pharmacies, which up to this point have been successfully negotiated with effective cost-saving considerations. TCC P.0, Box 2659, Austin Tx 78768 % 512-474-1798 * tuecorg 1Essentially, the new rules coud harm Part D beneficiaries in many important ways. According to one study performed by the Ametican Action Forum, the following results are likely in the event the rule changes take effect: [Regulations proposed by the Centers for Medicare and Medicaid Services (CMS) in January 2014 will mean that ar estimated 14 million seniors could lose thelt curcent plan, beneficiaries could see premium ircreases of up to 21 percent, and the changes could cost the Part D program up to $10 billon over the next ten years. While the Administration has pulled these proposed rules for now, we fully expect thet lo ley ea In that event, Congress must act to prevent these rules that undermine Part D from being Implemented. Representative Renee Ellmers of North Carclina had sponsored H.R 4160, entitled the “Kaep the Promise to Seniors Act.” H.R. 4160 provides, in part, that Notwithstanding any ether provision of the aw, the Secretary of Health and Human Services shall not take any action to implement any provision of the proposed regulation published on January 10, 2014 (79 Fed. Reg. 1918 et seq.) insofar as such regulation relates to the Provisions of [Medicare Part D]." H.R. 4160 is a useful model for future action. Nearly 400 interested groups have spoken out against the proposed rule changes, which is why the [Administration had to change course for now." The Texas Conservative Coalition joins these voices of ‘opposition. Some—like Affordable Care Act architect Jonathan Gruber—claim that Medicare Part D is an “experiment” in choice and that “seniors do a terrible job choosing.” We believe that choice is a {900d thing. Medicare Part C is a rare success story, and that success will be undermined if CMS’ proposed rule changes are adopted. When appropriate, we strongly urge you to use all resources at your disposal to prevent implementation, including public support and advancement of H.R. 4160 (or 2 similar measure) through Congres. Brand CJ jot loti Senator Brandon Creighton Senator Bob Devell Representative Cecil Bell, TCC % P.O, Eox 2659, Austin TX 78768 # 512-474-1798 * tmee-org 2Op~~i Boron Representative Dennis Bonnen Mug [gerne 0 Aeoresertatve Greg Bonen Ny aes Representative Cindy Burkett 1c he bite Representative Angle Chen Button Representative Travis Cardy Uh... Lathe Representative Allen Fletcher Ee Representative Ban Flynn 2570 Representative James Frank (1 7otlome— Repfoethtative Craig Goldmar CFiklhpcn— Representative Linda Harper-Srown ox Hla ae Kick onde~ Gp George Lavender ae Jeff Leach Gon fu Representatte Rick Miller Deame Of, thomons Representative Geanie W. Morrison fon opm Otto resentative John Otto fg! Representativg Scot Sanford Laue 7 Glee~ Representative Kenneth Sheets TCC % P.O, Fox 2659, Austin TX 78768 * 512-474-1798 ® biee.org 3ee Pe eo ‘Representative Drew Springer Vor | ey ire Representative Van Tayior Llt-r-—_— Representative Ed Thompson | ENDNOTES: ‘hp //americanactonfocumorg/earchemb rulemaking and-medicarepart-ttifingnovaton-mlingaccst and Shup:/energycommerce house gor/stes/epublcansenergyommerce house go/fles/BILS-113hr4160 pf ‘t/a be org/vog/ wp conten ploads/2014/02/emseter pe TCC % P.O, Fox 2659, Austin TX 78768 % 512-470-1798 trec.org 4