Kathy Hepner, RN, BSN

Closing the Donut Hole: Who Will Pay?

Tags: donut hole Health Care Reform healthcare system Legislature Medicare Medicare Supplement prescriptions

The dark black hole in the Medicare Part-D prescription plan called the donut hole is finding the light, or is it? Health care reform has promised to close the donut hole for Medicare recipients completely by the year 2020 (Gionfriddo, 2010). The Consumer Report on Health (2012) confirms medication costs continue to rise with no end in sight. Who will pay the gap between what is currently covered and the predicted added coverage with Health Care Reform? According to the Center for Medicare and Medicaid Services (CMS, 2011) the Medicare trust fund is currently running in a deficit. Reducing the burden of our Medicare population, with associated out-of-pocket expenses for prescription drugs, cannot be achieved by a system already running in a deficit. As we start to unravel the mystery behind closing the donut hole, can we identify who will pay?