March 24, 2014

Nearly 14,000 RIers Benefitted from Obamacare’s Medicare “Doughnut Hole” Fix in 2013

Medicare Beneficiaries Saving on Prescription Drugs and Preventive Services

Washington, DC – Thousands of Rhode Island seniors have saved on prescription drugs because of the Affordable Care Act, according to federal data released last week.  In 2013, 13,998 Rhode Islanders on Medicare saved over $9.9 million on their prescriptions, for an average savings of $709 per person.

Prior to the passage of the Affordable Care Act, thousands of Rhode Island seniors fell into the so-called Medicare “doughnut hole” and were forced to pay the full cost of their prescription drugs.  In 2010, U.S. Senator Sheldon Whitehouse successfully fought to eliminate the doughnut hole as part of the Affordable Care Act, enabling the savings they are seeing today.

The Affordable Care Act also made certain preventive services, such as annual wellness visits and mammograms, available at no out-of-pocket cost.  The new data released by the Centers for Medicare and Medicaid Services shows that from 2013 through the first two months of 2014, an estimated 26.5 million people with traditional Medicare – including 90,486 in Rhode Island – received at least one free preventive service.

“The Medicare doughnut hole hit seniors hard for years,” said Senator Whitehouse.  “Now they’re saving hundreds of dollars on their prescriptions, and gaining access to free preventive services they used to have to pay for.  The Affordable Care Act is making a big difference to Rhode Island seniors.”

The doughnut hole used to expose seniors to the full cost of prescription drugs after they and their plan spent a certain amount of money ($2,850) for covered drugs in a year, but before they hit catastrophic coverage ($4,550).  The Affordable Care Act has been closing the doughnut hole in phases since it was enacted in 2010.

Because of the Affordable Care Act, in 2011 and 2012 seniors in the doughnut hole received a 50% discount from the drug manufacturers on all brand-name drugs.  Starting this year, the federal government is subsidizing an additional 2.5% of brand-name drug costs for seniors in the doughnut hole.  These subsidies will increase each year until the coverage gap is closed in 2020.


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Meaghan McCabe, (202) 224-2921