As the third most powerful Democrat in the House of Representatives, Menendez, who represents the 13th Congressional District, has also seemed immensely strong, taking on political opponents or controversial issues with the stern expression of a professional.
But for one brief moment at the 56th Street Senior Center in Bayonne recently, his voice cracked and the stern congressman glanced down at the podium.
He had referred to his mother as an example of the struggle family members sometimes face in helping the elderly. His mother has Alzheimer's disease, and though he did not go into great detail, one look was enough to testify to his personal connection to the concerns of senior citizens.
Bayonne was one stop in his tour of his electoral district, where he was making a point of informing senior citizens about some of the hard choices they will face when the new Medicare Prescription Drug Plan comes into effect in 2006.
The new plan will be provided through private prescription drug plans, not through Medicare.
Each year, Medicare beneficiaries will have to select a drug plan. The law says people must have a choice of at least two plans offering prescription drug coverage, one of which may be an HMO.
"This is not just about senior citizens; it is about families," he said. "It is about those who are aging and those who have to take care of their aging loved ones."
He and his family have been trying to provide care for his 84-year-old mother, whose disease has increased her difficulty in her later years. In a voice that seemed to shift from sadness to anger, he said the government should be trying to help such people, not make it more difficult for seniors to get the prescriptions they need.
The new prescription plan approved by Congress last November is the most pervasive change in Medicare coverage since the program's implementation in 1965.
Although the scheduled presentation for Hoboken seniors was postponed earlier this month due to inclement weather, Menendez made an appearance at the 56th Street Senior Center in Bayonne. Using a video presentation that included veteran broadcaster Walter Cronkite, and was produced by the non-partisan organization Families USA, Menendez sought to explain the features of the drug program.
Menendez said the program was a Republican initiative that passed over the objections of the Democratic minority in both houses of Congress.
"We had other ideas that we wanted to see in a prescription plan," he said.
But he said that with the passage of the bill, he felt seniors needed to be educated about the intricacies of the law to make informed decisions about their own health care.
Seniors confused about changes
Recent polls by the Kaiser Foundation indicate that many seniors are still confused about the provisions of the plan. Menendez spent about an hour and a half telling seniors about the benefits and pitfalls of the plan.
"New Jersey is known as the Medicine Cabinet of the world, where many life-saving, life-enhancing drugs are developed and manufactured," Menendez said. "Unfortunately, the price of those medications put them out of reach for far too many of New Jersey's seniors."
The congressman said that as the cost of prescription drugs continues to skyrocket, many seniors are being forced to make hard choices, such as whether to take the drugs they need or pay rent and buy food.
Menendez said intense lobbying by prescription drug companies seemed to influence the direction of the Republican-dominated Congress.
What they'll have to pay
Under the new program, seniors will have to pay a $35 monthly premium, a $250 deductible, and 25 percent of drug expenses until costs reach $2,250. At this point, the new law reaches what critics have called "a donut hole," where seniors will have to pay out of pocket for the next $2,850 in drug expenses until they reach $5,100, at which point seniors qualify for catastrophic coverage.
This donut hole effect is yearly. In other words, seniors will have to pay the first $4,020 of $5,100 in drug benefits each year. Worse, the gap in coverage increases yearly, so that seniors will be forced to pay more and more of their prescription costs before qualifying for the catastrophic coverage.
Unlike the benefits the Veterans' Administration offers, this law prohibits the government from negotiating with drug companies for lower prices based on a bulk discounts.
"The bill also explicitly prohibits the government from negotiating lower drug prices on behalf of the 40 million Medicare beneficiaries, something we already do for our veterans and that we did during the anthrax scare in 2001," Menendez said.
While seniors can also opt to continue with the traditional Medicare program as it currently exists, the cost to participants will rise 12 percent per year for the next three years - which would strain many seniors with limited resources. Forced between higher costs and choosing one of the new plans, seniors could be forced to abandon doctors who currently treat them.
Menendez said the new law does provide a provision for those seniors with the lowest income. Senior citizens with incomes of $13,000 a year or less would have no gap in the coverage, no premiums to pay and no deductibles. But to qualify, a person could not have more than $6,000 in assets. This includes insurance, burial plans, home ownership or a bank account.
Employee and state plans at risk
The new plan could also affect private health care plans in several ways. Companies that currently offer better programs could abandon them, thinking the new federal plan will provide coverage. As it is, Menendez said, nearly four million seniors - of which 94,000 live in New Jersey - can expect to lose their employer-sponsored health coverage due to a lack of adequate incentives in the law to encourage private employers.
Worse for seniors is the fact that the federal law will have a sharply negative effect on states like New Jersey where there exists a comprehensive prescription plan. Menendez said people currently using New Jersey's two prescription programs will suffer when the law comes into effect in 2006.
People will no longer be able to purchase discount drugs from sources outside the United States, such as Canada, since the new law would outlaw such purchases, Menendez said.
Menendez said the plan could change if Congress acts before the 2006 start-up, and that organizations such as AARP, which previously endorsed the plan, seem to be having second thoughts.
"The only way this plan will change is if people speak out against it," he said.
A temporary discount plan offered?
Prior to the implementation, seniors will be allowed to participate in a discount drug program Menendez called disturbingly dishonest because promotions for the cards neglects to tell seniors that prices and drugs can change every seven days, so that discounts seniors may sign up for may be altered during the year-long subscription to the plan.
This discount plan starts this month and provides a choice of five card plans, the price of which starts at $30 a month.
Menendez said he was disturbed that the government-paid advertising that has failed to fully explain the downside of this temporary plan, and that he was going to file a complaint with the federal General Accounting Office in Washington, DC to make certain that all aspects of the card plan are presented for seniors to be able to make educated decisions.