CMS Predicts 90% Coverage Under Medicare Drug Benefit

A surge in enrollment before the May 15 deadline for signing up for the Medicare prescription drug benefit could mean that more than 90% of Medicare beneficiaries will have prescription drug coverage in the first year of the program, CMS Administrator Mark McClellan said on Monday, CQ HealthBeat reports. The Bush administration last Wednesday said about 37 million Medicare beneficiaries -- or 85% of the approximately 43 million total beneficiaries -- had some form of prescription drug coverage. According to CQ HealthBeat, "Breaking 90% would put that figure at about 38.7 million" (Reichard, CQ HealthBeat, 5/15).

CMS spokesperson Lorraine Ryan said about 72,000 beneficiaries signed up for the drug benefit online on Friday, three times the number who enrolled online the previous Friday (Salganik, Baltimore Sun, 5/16).

Over the weekend, five times as many beneficiaries enrolled online than had the previous weekend, McClellan said. In addition, as many as 40,000 to 50,000 people were on the Medicare Web site at any given time over the last few days, he said. Calls to 1-800-MEDICARE averaged about 300,000 per day last week, compared with 200,000 to 250,000 the week before, McClellan said (CQ HealthBeat, 5/15).

The agency was receiving about 140,000 calls per day two months ago, Ryan said. Better estimates of final enrollment figures should be available Tuesday, she said (Baltimore Sun, 5/16).

McClellan said, "We've seen a real surge. The deadline is making a difference" (Freking, AP/Long Island Newsday, 5/16).

Across the U.S. on Monday, state and local governments, advocacy groups, seniors' organizations, insurers and pharmacies held enrollment events to encourage beneficiaries to sign up before the deadline, after which most beneficiaries will have to pay a penalty (Baltimore Sun, 5/16). Beneficiaries who were eligible to enroll in the drug benefit Monday who did not sign up will have to pay a penalty of a 1% premium increase 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 and beneficiaries with disabilities 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, 5/15).

In Washington, McClellan, HHS Secretary Mike Leavitt and first lady Laura Bush attended an enrollment event at a church.

Administration officials and other groups participated in about 1,000 similar events across the country in the last week, CMS spokesperson Peter Ashkenaz said (CQ HealthBeat, 5/15).

Nationwide, My Medicare Matters, an affiliate of the National Council on Aging, held more than 3,000 events (Baltimore Sun, 5/16). In addition, at least 12 Republican House members planned to keep their offices open until midnight Monday to help beneficiaries enroll, while other lawmakers held events in their congressional districts (Wolf, USA Today, 5/16).

Meanwhile, calls to insurers -- which had been urged by the Bush administration to add extra phone operators to handle the last-minute enrollment surge -- showed varying wait times Monday, the New York Times reports. Calls to UnitedHealthcare generally were answered in less than two minutes, but callers to Humana often had waits of more than 30 minutes, according to the Times. Calls to 1-800-MEDICARE often took more than 15 minutes (Pear, New York Times, 5/15).

Beneficiaries who called the Medicare phone line on Monday but were unable to get through could leave their names and phone numbers, and they would be called back within a few days to enroll without penalty, Ryan said (Baltimore Sun, 5/16). Medicare officials also told insurers they could accept incomplete applications on Monday if beneficiaries provided the missing information soon after the deadline.

On Humana's phone line, callers were told they could "meet enrollment deadline requirements" by leaving their names and phone numbers on an answering machine. Callers were told that a Humana representative would "call [them] back in the next few days" to help choose a drug plan (New York Times, 5/16).

Meanwhile, House Ways and Means Health Subcommittee Chair Nancy Johnson (R-Conn.) on Monday said she was drafting legislation that would eliminate the late-enrollment penalty for beneficiaries who missed Monday's deadline. The bill would maintain Nov. 15 as the start of the next enrollment period but would waive the late-enrollment penalty for beneficiaries who were eligible this enrollment period who did not sign up.

A press release from Johnson's office said she will introduce the bill as "quickly as possible" for consideration before the current legislative session adjourns (CQ HealthBeat, 5/15).

Jill Gerber, a spokesperson for Senate Finance Committee Chair Chuck Grassley (R-Iowa), said the senator will not make a decision on whether he supports eliminating the penalty until after he sees final enrollment figures, which could be as early as Tuesday (Schuler, CQ Today, 5/15).

Karen Ignagni, president of America's Health Insurance Plans, said her group supports waiving the penalty, adding that doing so would act as an incentive to encourage more beneficiaries to sign up (CQ HealthBeat, 5/15).

AARP also has expressed support for waiving the penalty (Alonso-Zaldivar, Los Angeles Times, 5/16).

Several broadcast programs reported on the enrollment deadline for the Medicare prescription drug benefit:

• APM's "Marketplace Morning Report": The segment includes comments from Robert Laszewski, political analyst and health consultant for the insurance industry, and Joe Paduda, a health care consultant (Tong, "Marketplace Morning Report," APM, 5/15). The complete segment is available online in RealPlayer.
  
  
• CBS' "Evening News": The segment includes comments from Medicare beneficiaries (Andrews, "Evening News," CBS, 5/15). The complete segment is available online in RealPlayer.
  
  
• KCRW's "To The Point": The segment includes comments from CMS Administrator Mark McClellan; Tricia Neuman, a Kaiser Family Foundation vice president and director of its Medicare Policy Project; Ron Pollack, executive director of Families USA; Rob Pollock, member of the Wall Street Journal editorial board; and Medicare beneficiaries (Olney, "To The Point," KCRW, 5/15). The complete segment is available online in RealPlayer.
  
  
• KPBS' "KPBS News": The segment includes comments from Gary Passmore, executive director of the Congress of California Seniors (Goldberg, "KPBS News," KPBS, 5/15). The complete transcript is available online. The complete segment is available online in RealPlayer.
  
  
• KPCC's "AirTalk": The segment includes comments from Jeff Flick, regional administrator for CMS in San Francisco; Theodore Marmor, professor of public management and political science at Yale University; and Benjamin Zycher, senior fellow at Manhattan Institute's Center for Medical Progress (Mantle, "AirTalk," KPCC, 5/15). The complete segment will be available online in RealPlayer.
  
  
• KPCC's "KPCC News": The segment includes comments from Mark Beech, a Sacramento-based spokesperson for AARP; Jerry Flanagan, health care policy director at the Foundation for Taxpayer & Consumer Rights; Flick; and Medicare beneficiaries (Baer, "KPCC News," KPCC, 5/15). The complete segment is available online in RealPlayer.
  
  
• KQED's "The California Report": The segment includes comments from Flick (Baer, "The California Report," KQED, 5/15). The complete segment is available online in RealPlayer.
  
  
• PBS' "NewsHour with Jim Lehrer": The segment includes comments from Dan Mendelson, president of Avalere Health, a health care consulting firm, and Pollack (Suarez, "NewsHour with Jim Lehrer," PBS, 5/15). The complete segment is available online in RealPlayer.