U.S. Rep. Phil English

1410 Longworth House Office Building

Washington, D.C. 20515

www.house.gov/english

                                                                                                                                                                                                         

News for immediate release          CONTACT: Julia Wanzco

September 26, 2006                                                       (202) 225-5406

 

English, Rush Move to Modernize Medicare

New Measure will Expand Medigap to Cover Disabled

 

Washington, D.C. – Today, U.S. Reps. Phil English (R-Pa.) and Bobby Rush (D-Ill.) introduced bipartisan legislation, H.R. 6175, the Medigap Access Improvement Act, to expand access to Medigap supplemental insurance to include all Americans with disabilities. Currently only 24 states mandate that Medigap be offered to those in Medicare due to disability.

 

“Faced with already high medical expenses, the 20 percent coinsurance under Part B forces disabled beneficiaries to bear the brunt of an unfair financial burden for life-saving treatments,” said English, a member of the House Ways and Means Health Subcommittee.  “While the Commonwealth of Pennsylvania guarantees supplemental coverage for our disabled, other states do not.  We must move to fix this long standing inequity in Medicare and establish a federal standard for equal access to these policies.”

 

“This bill levels the playing field for all Medicare beneficiaries to access supplemental insurance, regardless of the state in which they live,” said Rush, a member of the House Energy and Commerce Committee.  “Beneficiaries who quality for Medicare due to disability deserve the same options for meeting their financial responsibilities as other program participants.  I urge my colleagues to join us in this effort.”

 

Under current law, Americans qualify for Medicare due to disability and rely on Part B coverage to access essential medical treatments.  Under Medicare Part B, which provides coverage for doctor’s services, outpatient hospital care and diagnostic tests among other services, there is an annual deductible of $124.00 for covered care.  After the deductible, beneficiaries are required to pay a 20 percent coinsurance of the services received.  Often times, beneficiaries will purchase supplementary coverage, known as “Medigap,” through private insurers to cover these costs. In many states, Medigap open enrollment protections provided to aged beneficiaries are not extended to those who qualify for Medicare because they are disabled.  To date, only 24 states mandate that Medigap be offered to those in Medicare due to disability.

 

The Medigap Access Improvement Act would update the Medicare program to guarantee access to Medigap supplemental policies for disabled beneficiaries enrolled in Part B.  Expanding existing Medigap enrollment protections to include beneficiaries with disabilities who are under the age of 65 will help disabled Americans obtain assistance with the high costs of life-saving therapies without placing any financial or administrative burden on the Medicare program.

In addition, this change will level the playing field by providing the same opportunity to purchase the Medigap policies offered to beneficiaries age 65 and older.

 

 

 

 

“The legislation being put forward by Congressmen English and Rush will be of great help for those who are on Medicare due to disability.  People with hemophilia have a chronic condition and rely on a lifetime's worth of blood clotting factor, which can be very expensive,” said Kerry Fatula, Executive Director for the Western Pennsylvania Chapter of the National Hemophilia Foundation.  “Asking anyone, let alone someone who is disabled with hemophilia to pay 20% of $100,000 or more worth of clotting factor on an annual basis is a tremendous financial burden.  This bill will assist the disabled who cannot meet this copayment while also allowing them to participate in the financial responsibility of supplemental insurance through the payment of premiums and deductibles.”

 

“With this bill, millions of disabled Americans will finally be able to meet their Medicare cost sharing responsibilities and maintain access to the life-saving treatments they need,” English concluded.   

 

The Medigap Access Improvement Act has been endorsed by the National Hemophilia Foundation, the Hemophilia Federation of America, the Committee of Ten Thousand, and the Guillain-Barré Syndrome/Chronic Inflammatory Demyelinating Polyneuropathy (GBS/CIDP) Foundation International among others.

 

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