Can federal legislation affect the availability of medical treatment for our patients with glaucoma? This quandary is the fundamental question asked by Blumberg et al1 in this issue in their assessment of the influence of the introduction of Medicare Part D on rates of prescription drug coverage and out-of-pocket spending for patients who require ocular hypotensive medications. Using data from the Medicare Current Beneficiary Survey (MCBS), they determined that from 2004 to 2005 (the period before Part D was available) to 2007 to 2008 (the period after Part D was available), the percentage of beneficiaries without prescription drug coverage was reduced dramatically for their designations of persons characterized as poor, near poor, and those with higher incomes (from 23% to 4%, 29% to 7%, and 20% to 4%, respectively) but that out-of-pocket costs for ocular hypotensive agents were reduced primarily only for the poor who acquired coverage through Part D.