1M Enroll in Last Week of Drug Benefit Sign Ups
An estimated one million Medicare beneficiaries signed up for prescription drug coverage in the week leading up to Monday's enrollment deadline for the Medicare prescription drug benefit, HHS Secretary Mike Leavitt said on Tuesday, the Washington Post reports (Goldstein/Murray, Washington Post, 5/17). Leavitt predicted that 38 million of the approximately 42.5 million Medicare beneficiaries will have some form of drug coverage when enrollment data are finalized (Graham, Chicago Tribune, 5/17).
The 38 million figure would mean about 90% of beneficiaries would have drug coverage (USA Today, 5/17).
CMS Administrator Mark McClellan said that 872,000 beneficiaries signed up last week but that it is unknown how many enrolled over the weekend or on Monday (Washington Post, 5/17). McClellan noted that online enrollments alone on Monday totaled 143,875 beneficiaries (Pear, New York Times, 5/17).
McClellan and Leavitt said an estimated 4.5 million Medicare beneficiaries still do not have prescription drug coverage, including about three million who are eligible for a low-income subsidy that offers low copayments and other discounts (USA Today, 5/17).
Leavitt said the enrollment projections were based on "very good estimates" (Washington Post, 5/17). He added, "It needs to be noted what a remarkable American experience this was. The American people ought to be proud of themselves. There was a network of caring that was observable during the past six months" (Reichard, CQ HealthBeat, 5/16).
McClellan said, "Anybody who had any doubt that seniors could choose coverage that gives them what they want at lower cost needs to look at what we did here." He added, "No question it has been some effort for them to get into coverage, but they are saying it has been worth the effort" (Alonso-Zaldivar, Los Angeles Times, 5/17).
In related news, The Hill on Tuesday examined how the Bush administration and Republicans in Congress are "trumpet[ing]" drug benefit enrollment figures "as a boon to seniors and the governing party" at the same time as Democrats "have seized on the same number to brand the program a failure" (Young, The Hill, 5/16).
Meanwhile, Senate Finance Committee Chair Chuck Grassley (R-Iowa) and a bipartisan group of senators on Tuesday introduced a bill that would eliminate the late-enrollment penalty for Medicare beneficiaries who missed Monday's deadline, the Tribune reports (Chicago Tribune, 5/17). Under the current late-enrollment policy, beneficiaries who were eligible to enroll by Monday who did not sign up will be charged a 1% increase in premiums for each month of delayed enrollment.
Because the next enrollment period begins Nov. 15, beneficiaries would pay a minimum late-enrollment penalty of 7%. Beneficiaries who qualify for a low-income subsidy under the drug benefit are exempt from the penalty. Hurricane Katrina evacuees also will be allowed to enroll without a late-enrollment penalty for 63 days after May 15 but will have to pay a 2% penalty beginning the 64th day (California Healthline, 5/16).
Grassley's bill, co-sponsored by Sens. Max Baucus (D-Mont.), Bill Nelson (D-Fla.) and Mike DeWine (R-Ohio), would waive the penalty for beneficiaries who enroll for 2007 during the next open enrollment period (Chicago Tribune, 5/17). The legislation also would provide $18 million for efforts to help more beneficiaries enroll (Fagan, Washington Times, 5/17).
House Ways and Means Health Subcommittee Chair Nancy Johnson (R-Conn.) introduced a companion bill in the House on Tuesday (Heil, CongressDaily, 5/16).
According to Grassley, waiving the penalty for 2007 would cost about $1.7 billion over five years (Washington Post, 5/17). He proposed offsetting the loss of funding by taking money from the "stabilization fund" established under the 2003 Medicare law to encourage insurers to offer Medicare drug plans in underserved areas (CongressDaily, 5/16).
Grassley said, "We can help more seniors choose to sign up by waiving the enrollment penalty" (Chicago Tribune, 5/17). He added, "It stands to reason that it takes time for people to learn about benefits available to them. The more participants in Medicare Part D, the better for both the program's strength and seniors' quality of life."
Grassley said he hoped to bring the bill to the Senate floor as early as Tuesday night.
Carolyn Weyforth, a spokesperson for Senate Majority Leader Bill Frist (R-Tenn.), said the senator "is open to offering seniors who didn't enroll a second chance." She added, "For those who did not enroll in time, they're going to be without coverage for the rest of the year. "[Sen. Frist] thinks that that's penalty enough, so he's going to look at what Grassley and Baucus offered" (Sheffield, The Hill, 5/17).
Nelson said that "eliminating a 7% penalty on seniors citizens' premium payments ... is clearly in the interest of our senior citizens" (Freking, AP/South Florida Sun-Sentinel, 5/17).
House Majority Leader John Boehner (R-Ohio) "seemed skeptical of the idea" of waiving the penalty, CongressDaily reports. Boehner said, "There is a cost associated with extending the deadline. So the question is: How is it paid for?" He added, "I think I would leave it to [Ways and Means Committee Chair Bill] Thomas (R-Calif.) at this point to do his hearings to learn about where we are and if there is anything we can do to be helpful" (CongressDaily, 5/16).
The Senate Democratic Policy Committee said in a statement that Democrats want the enrollment deadline extended and beneficiaries to be able to change plans after enrollment (Washington Times, 5/17).
House Republican Study Committee Chair Mike Pence (R-Ind.) said passage of Grassley's bill would be "the first crack in the wall of expanding [the drug benefit] entitlement." Pence said Republicans are in danger of losing majority control of the House if they do not show more fiscal conservatism (May, CongressDaily, 5/17).
Leavitt said, "There will be value in waiting to see whether or not [legislation] is needed. We don't have a lot of the facts, yet." He added, "That'll be Congress' decision, but it might be well for them to determine what it looks like a week from now."
McClellan said, "When you have new legislation, you always have to find a new way to pay for it." Referring to the proposal for funding the legislation with money from the insurers' stabilization fund, McClellan said that next year "won't be a good time to tighten down on payments to those health plans that are already saving more and more seniors a lot of money"(CQ HealthBeat, 5/16).
White House Press Secretary Tony Snow said, "That's a bill (that) was dropped in the hopper just a couple of hours ago, and just as we've said to members of the House and Senate, 'Take a good look at the president's proposals,' we'll take a good, careful look at that" (CongressDaily, 5/16).
AARP CEO Bill Novelli said, "Confusion during this first year has left some without important coverage. Waiving the late-enrollment penalty makes good sense" (Wall Street Journal, 5/17).
James Firman, president of the National Council on Aging, said, "Phase one is complete, but there is a lot more to be done." He added, "We will know a lot more about how satisfied people are with their choices when more of them start hitting the doughnut hole" in coverage, in which beneficiaries are responsible for all prescription drug costs between $2,250 and $5,100 per year.
Robert Blendon of the Harvard School of Public Health said, "The big issue about this program no longer has to do with who has enrolled. The issue is how it's going to work between now and November" (Los Angeles Times, 5/18).