Democrats, Republicans Debate New Medicare Prescription Drug Discount Drug Card Program at Hearing

During a House Energy and Commerce Committee hearing Thursday, lawmakers provided different accounts of "confusion among [beneficiaries] about the new Medicare prescription drug cards, long waits for help in choosing the right card and errors in government-listed drug prices," CongressDaily reports (Heil, CongressDaily, 5/20). The discount card program, created as part of the new Medicare law, is available to Medicare beneficiaries who do not have prescription drug coverage through Medicaid. Discount card sponsors can charge an annual enrollment fee of as much as $30 and likely will offer savings on at least one medication in each of 209 classes of treatments commonly used by Medicare beneficiaries. Medicare beneficiaries with annual incomes of less than $12,372 for individuals or $16,608 for couples will qualify for a $600 annual subsidy for their prescription drug costs and will not have to pay enrollment fees. Beneficiaries can use the Medicare Web site or call 1-800-MEDICARE to make card-to-card comparisons of prescription drug discounts. According to HHS Secretary Tommy Thompson, the discount cards provide average savings of about 10% to 17% for brand-name medications and 30% to 60% for generic treatments. Enrollment in the program began this month, and the cards take effect in June (California Healthline, 5/18).

Democrats called problems with the cards "a symptom of fundamental flaws in the program and feared the problems ultimately might erode public faith in Medicare," CongressDaily reports (CongressDaily, 5/20). Rep. Bart Stupak (D-Mich.) said, "This drug card fiasco is not what seniors want or what they deserve" (MacDonald, Hartford Courant, 5/21). Rep. John Dingell (D-Mich.) said that if the cards do not offer beneficiaries promised discounts, it "could undermine the trust seniors have in Medicare." Dingell is planning to introduce legislation that would automatically enroll low-income beneficiaries in the discount card program. According to CongressDaily, Dingell is concerned about confusion among beneficiaries eligible for the $600 subsidy and the Bush administration's reluctance to enroll seniors automatically. Republicans said that the problems with the cards that Democrats outlined are "minor glitches" that will be worked out, CongressDaily reports. Energy and Commerce Health Subcommittee Chair Rep. Michael Bilirakis (R-Fla.) said, "Any program this massive is going to have start-up problems." He added that the reported confusion among beneficiaries is caused by competition among card sponsors, saying, "I don't apologize for giving seniors choices -- that's a good thing" (CongressDaily, 5/20). However, "even some Republicans have moderated their enthusiasm" for the program, the Courant reports. Rep. Joe Barton (R-Texas) said, "There are some glitches. It's a startup program" (Hartford Courant, 5/21).

During the committee hearing, CMS Administrator Mark McClellan defended the program against Democrats' assertions that is confusing and not likely to produce significant savings for beneficiaries, the AP/Las Vegas Sun reports (AP/Las Vegas Sun, 5/20). He said, "We recognize there have been some operational problems [with the discount cards]. ... The initial phase of a major new program is clearly a time of learning" (Hartford Courant, 5/21). McClellan cited a government study that showed the lowest prices on prescription drugs offered discounts up to 18% off the retail prices. He also said that the agency had hired more than 2,000 operators for 1-800-MEDICARE to decrease the waiting time for callers to no more than 15 minutes at peak calling times (Sherman, AP/Las Vegas Sun, 5/20). In addition, he said that the new Medicare price comparison Web site has a new feature to help beneficiaries enter the correct spelling of drug names (Hartford Courant, 5/20). McClellan told reporters after the committee hearing that automatic enrollment "may be something we can work out if it turns out [that] other mechanisms do not work." He said that CMS initially is using an education and recruitment campaign to enroll as many low-income beneficiaries as possible, the AP/Sun reports (AP/Las Vegas Sun, 5/20).

The Washington Post on Friday looked at the discount cards' "shifting drug prices," which have "made it nearly impossible" for some beneficiaries to select a card. According to the Post, because a card sponsor can change listed prices once per week, "a card that's best for a senior citizen one week may be the worst the next week" (Brubaker, Washington Post, 5/21).