 These late-1990s/2000 proposals—with the exception of the spend phase structure but including the fact that Medicare itself would not do the negotiating—are substantially the same as the current Part D. The major change since passage has been the gradual reduction of the "donut hole" co-pay from 100% to 25%.Prescription drug prices were rising and the population most vulnerable to those rising prices were senior citizens.Then President George W. Bush pushed the Medicare Part D through the House in 2002 but, then it stalled in the Senate.