Final Drug Benefit Enrollment Data Released

Final Medicare prescription drug benefit enrollment data show that about 11.5 million Medicare beneficiaries voluntarily enrolled in the program before the May 15 deadline, bringing the total number of Medicare beneficiaries with prescription drug coverage to 38.7 million, HHS officials said on Thursday, the AP/Detroit Free Press reports (Freking, AP/Detroit Free Press, 6/9). In a fact sheet released on Thursday, CMS said that more than 90% of all beneficiaries "have good drug coverage."

The total enrollment figure includes beneficiaries who were automatically enrolled in Medicare drug plans, federal retirees and beneficiaries who receive coverage through former employers that receive a subsidy from Medicare (Reichard, CQ HealthBeat, 6/8). The final enrollment figures indicate that four million to five million beneficiaries are still without drug coverage, the AP/Free Press reports (AP/Detroit Free Press, 6/9).

HHS Secretary Mike Leavitt said more than two million beneficiaries obtained drug coverage between May 1 and the May 15 enrollment deadline. CMS Administrator Mark McClellan said the agency would release more detailed data on coverage sources soon.

Many of the beneficiaries who signed up in the last two weeks before the deadline are in good health, which will help keep premiums from increasing significantly next year, CMS officials said (CQ HealthBeat, 6/8). Leavitt said beneficiaries chose plans with monthly premiums averaging $23 (AP/Detroit Free Press, 6/9). Last year, Medicare actuaries estimated monthly premiums would average $37.

McClellan said CMS will use its authority to ensure the bidding process will allow low-income beneficiaries to continue to have access to no-premium plans.

According to a CMS spokesperson, without such intervention from the agency, low-income beneficiaries likely would have to switch plans next year to maintain no-premium coverage. "[O]ur intent is to determine how to make adjustments as necessary to moderate premium increases for all beneficiaries," CMS said in a release, adding, "We expect that this will result in premiums that will increase on average by about medical inflation, but that will depend on actual plan bids."

CMS also said in July it expects to announce a further "significant downward revision" in the cost of the drug benefit. Last month, the Medicare trustees in their 2006 report projected that the cost of the drug benefit would be 20% lower than 2005 estimates. According to the CMS release, "By choosing plans that met their needs at a much lower cost than expected, both beneficiaries and taxpayers are saving more than expected" (CQ HealthBeat, 6/8).

Leavitt said, "I'd just like to stress what good news this is for our seniors and the Medicare program," adding, "Competition works. The costs are lower and enrollment in Medicare drug coverage is stronger than expected." The Bush administration in January 2005 projected that about 39 million beneficiaries would obtain coverage through the drug benefit.

However, Robert Hayes, president of the Medicare Rights Center, said, "The moral dilemma is that the people in greatest need are the people still unenrolled," adding, "Unless we can dramatically increase the number of the poorest Americans in this program, we need to re-examine the best way to meet the primary objective of the law" (AP/Detroit Free Press, 6/9).

Senate Finance Committee Chair Chuck Grassley (R-Iowa) said in a statement that the actions announced on Thursday by CMS "will ensure that low-income beneficiaries continue to have a choice of plans in 2007 that have a premium of zero. It also will minimize the need for people to switch plans just to continue to be enrolled in a zero-premium plan" (CQ HealthBeat, 6/8).