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The enactment of the Affordable Care Act (ACA), which was passed in 2010, ensured that the coverage gap or, so-called "doughnut hole", would be closing for patients on Medicare Part D. From this point now until 2020, both brand-name drug manufacturers as well as the federal government will be responsible for providing subsidies to patients in the doughnut hole. There will be an annual cumulative decrease in drug costs for those in the doughnut hole until 2020. For instance, in 2011, a 50% mark down off brand-name medications, financed by the manufacturer, and a 7% mark down off generic drugs by the government was introduced for patients in the doughnut hole. These reductions on generic drug costs will continue to incrementally rise at a rate of 7% until 2019. The following year in 2020, an extra cost reduction will be imposed at 12%, equating to a total of 75% of the generic drug cost covered. Similarly, for brand name drugs, the government will provide a subsidy at a rate of 2.5% beginning in 2013 and escalating to 25% in 2020. Thus, by 2020, Medicare Part D patients will only be responsible for paying 25% of the cost of all prescription medications, following payment of their deductible that year. Moreover, once patients enter the catastrophic threshold, they are only responsible for 5% of the drug cost.