Click here to watch video.

 Mr. BURGESS. Mr. Speaker, we heard a lot last spring about the voluntary Part D prescription drug program that seniors had available to them for the first time. We haven't heard much about it recently, but it is important to revisit the concept because of two aspects.

   One is the open enrollment period, which is going to begin the middle of November and run through the end of the year; and the other is to address the fact that some seniors are coming upon what is called the coverage gap. They have received enough help in the prescription drug program, and they have come into a period of spending where they are expected to cover the whole cost of their prescription drug components until they get up to a catastrophic level, after which they will only be responsible for 5 percent of their drug expenditures.

   Mr. Speaker, last spring when we talked about the Medicare prescription drug program back home, I would tell my constituents to focus on cost, coverage and convenience. If cost is your biggest driver, then look for the plan that has the lowest cost. That is pretty easy to do if you have got a computer and can go to Medicare.gov and scroll through the various computer screens of the plans out there.

   In my State in Texas, there were some 48 different plans and combinations of plans that were available, but it is pretty easy to pick out the ones that are the lowest cost. If cost was the main driver, that is what I would encourage people to do, and then focus in on those three or four that were the lowest-cost plans.

   If coverage was the main driver, there was a column devoted to coverage as well. You can certainly pick and choose from plans that covered 95, 98 percent or even 100 percent of the drugs in the Medicare formula.

   Finally, convenience. If you want to use mail order, make sure that the program that you are looking at conforms to that expectation. If you want to use the Wal-Mart pharmacy, if you want to use the mom-and-pop drugstore down on the corner, make certain that that dispensing entity is available on the drug plan.

   But by focusing on cost, coverage and convenience, then this rather daunting prospect of looking at 48 different drug plans became a whole lot easier.

   Remember, Mr. Speaker, when we passed the Medicare drug prescription program, the idea was with the finite number of dollars we had available we were going to cover the people most in need. That meant the people who had the most trouble with illness, who were on the most medications, and those people who were the least well off. The sickest and the poorest received the greatest amount of help from the Medicare prescription drug program. And that indeed has been borne out. But of necessity, those of us who are more well off or perhaps not as ill will find ourselves exposed to some expenditure for prescription drugs in the so-called coverage gap.

   Well, 92 percent of the people who signed up for Medicare are not affected by the coverage gap. That is, 45 percent of all Medicare beneficiaries will be eligible. Some fall into a category where they are eligible for low-income subsidies and therefore not affected by the gap. They have annual drug expenditures well below the $2,250 level and will never reach the gap, or they have chosen an enhanced Part D plan that provides some coverage in the coverage gap. An additional 47 percent have prescription drug coverage from plans outside of Part D, government plans, veterans plans or another Federal program, or an employer-sponsored program. Or there are those 9 percent who just said, I don't get sick, I don't need drugs, I don't take drugs, and I am not going to sign up. Forty-seven percent of Americans fall into that group. So 92 percent of people will never be affected by the coverage gap.

   But of those 8 percent who are, and this is the most important part, they need to concentrate on one of the enhanced plans when the open enrollment period comes up on the 15th of November.

   Every Medicare beneficiary, every single Medicare beneficiary, 100 percent are covered for catastrophic.

   What I would like to do with the balance of the time is to focus on the individuals who would benefit from being on an enhanced drug program.

   Mr. Speaker, I have just taken a random page from some of the plans that are available in my State of Texas. This is what will appear on someone's computer screen. You have the company name, the plan name, monthly drug premium, the annual deductible, the cost-sharing coverage in the gap, the formulary percentage of drugs covered, and a checkmark for whether or not someone is enrolled in that plan.

   If the plan you are in leaves you exposed in the coverage gap, I encourage people to go back to the computer screen or have their grandchild go to the computer for them and scroll through the plans available.

   If you look down, Mr. Speaker, you will find that some of the plans, albeit they are more expensive from the standpoint of the monthly premium, but look, here is one with a zero dollar annual deductible. Yes, it has some cost sharing, between $2 and $40. Coverage in the gap, yes. Generic only, but if a person is on a blood pressure medicine, cholesterol-lowering medication or reflux medication, this may be a very valuable plan. And then the one right below it, again no deductible, but generic and branded.

   This is the type of coverage someone needs to focus on if they found themselves having the expenditures in the so-called coverage gap.