Bush Promotes New Medicare Prescription Drug Benefit in Minnesota

President Bush on Friday launched his "grassroots effort to educate people" about the new Medicare prescription drug benefit at an invitation-only event for about 400 people in Maple Grove, Minn., the St. Paul Pioneer Press reports. Speaking before seniors, health care providers and Republican supporters, Bush said, "We're here to say to the seniors who live here in Minnesota and around the country that Medicare has been strengthened, reformed and modernized" (Salisbury/Olson, St. Paul Pioneer Press, 6/18). Bush said that the new drug benefit, which begins Jan. 1, 2006, is "a good deal for everybody, but it's a really good deal for low-income seniors" (Raum, AP/San Francisco Chronicle, 6/17).

He said, "[T]he reason why we're beginning to dialogue early on a Medicare plan that becomes available next November is because we want low-income seniors to fill out some paperwork to justify their participation in the program" (CQ HealthBeat, 6/17). Calling the campaign a "massive education" effort, Bush asked for help from caregivers, children of seniors and community- and faith-based organizations to spread the word (AP/San Francisco Chronicle, 6/17). "If we rely only on the federal government to get out the word, it's not going to work," he said (CQ HealthBeat, 6/17).

"It's going to take a lot of folks working a lot of hours to get the word out. This country can do a lot of amazing things when people put their mind to it. This is a call. By responding to the call, you're going to help make somebody's life a lot better," Bush added (Schmickle, Minneapolis Star Tribune, 6/18). According to the Washington Post, Bush promoted the "choices" offered to beneficiaries under the new drug benefit but did not provide many specific details (Connolly, Washington Post, 6/18).

Hubert Humphrey, president of AARP Minnesota, said, "I welcome the president to our state. I am very pleased he's talking about the Medicare drug benefit, and we will help him in that effort to educate millions of Medicare beneficiaries" (Pear, New York Times, 6/18).

Rep. Betty McCollum (D-Minn.) said, "President Bush's campaign to promote a flawed Medicare law is costing taxpayers hundreds of millions of dollars, and even his own experts are confused about how the program works" (St. Paul Pioneer Press, 6/18). She added that she will advise constituents to be "very careful" when assessing the new drug benefit. "We don't know exactly what the drug benefit will look like, and we don't know how much it will cost," she said. McCollum added that too many options could increase concerns of "seniors and retirees who are already feeling very insecure" because of doubts about Social Security and private pensions (New York Times, 6/18).

Rep. Pete Stark (D-Calif.) also commented on Bush's promotional campaign, saying the benefit is "inadequate and overly complex" and the president's "rhetoric [on Friday] will only confuse seniors and people with disabilities further." He added, "The president's materials fail to mention the gap in coverage for seniors, often called the doughnut hole. There is no mention that, while plans can periodically change the drugs they cover, seniors are locked into a plan for a full year." A CMS spokesperson responded to Stark's comments, saying that not all beneficiaries will be locked into a plan for a full year. He noted that dual eligibles, beneficiaries who qualify for both Medicare and Medicaid, will be able to switch plans each month.

Stark also released a commentary on the Bush administration's talking points for the new prescription drug benefit. Referring to the gap in coverage, the commentary says "under the standard benefit, the average person will run out of coverage in August 2006 but still be required to pay premiums for the rest of the year." The commentary also says that "if you qualify for full premium assistance, your 'choice' is limited to plans with average or below-average premiums. Those plans will likely have more restrictive formularies ... and millions of low-income people will be enrolled in plans that don't cover the drugs they need." The commentary says that despite the problems, "people who are eligible for the low-income subsidies should take advantage of the help. But they should choose carefully, and care must be taken to help them understand that it is a two-step process -- applying for the subsidy and choosing a plan" (CQ HealthBeat, 6/17).

According to the Times, Bush "was greeted" in Minnesota by "people protesting his plan to overhaul Social Security" (New York Times, 6/18). According to the Star Tribune, the demonstrators linked Social Security and Medicare, saying that Bush's plan for Social Security would weaken both programs (Minneapolis Star Tribune, 6/18). Janice Stover, president of AARP Idaho, said that seniors link Medicare and Social Security because Medicare premiums are deducted from monthly Social Security checks.

"People will think about the future of Social Security as they decide whether to sign up for the Medicare drug benefit," she added. Bush did not mention Social Security in his comments on Friday. CMS Administrator Mark McClellan said, "In the whole discussion about Social Security, no one is talking about any changes in benefits for people who are in the program now or close to it. The new Medicare benefits are coming right away, to help people get up-to-date health care coverage. That's very different" (New York Times, 6/18).

In related Medicare news, the American Medical Association this week launched an ad campaign featuring an announcer who warns that a scheduled 26% reduction in Medicare payments for physician services will force doctors to limit the number of beneficiaries they treat (Minneapolis Star Tribune, 6/18).

The new Medicare drug benefit is a "prescription for soaring costs" because a "fatal flaw" in the 2003 Medicare law "explicitly forbids the federal government from directly negotiating cut-rate bulk pricing of medications," an Atlanta Journal-Constitution editorial states.

Now "Medicare officials are tying the hands of insurance companies to do the same thing" by requiring that drug plans cover all medications in certain classes, the Journal-Constitution continues, adding that insurers' ability "to bargain for the best prices" will be limited, "forcing either higher premiums or increased taxes" to pay for the higher costs (Atlanta Journal-Constitution, 6/20).

NPR's "All Things Considered" on Friday reported on Bush's campaign to promote the Medicare prescription drug benefit. The segment includes comments from Bush and a volunteer at the community center in a Minneapolis suburb where Bush spoke about the benefit (Greene, "All Things Considered," NPR, 6/17). The complete segment is available online in RealPlayer.