Medicare Prescription Drug Benefit Changes Not ‘Off the Table,’ Legislators Say
Some House Republicans "are expressing a growing interest" in amending the Medicare prescription drug benefit, as they work on Social Security, despite earlier comments by President Bush that he would reject any changes, The Hill reports (Cusack, The Hill, 3/3). At HHS Secretary Mike Leavitt's swearing-in ceremony in February, Bush warned Congress not to reopen the new Medicare law, saying, "I signed Medicare reform proudly, and any attempt to limit the choices of our seniors and to take away their prescription drug coverage under Medicare will meet my veto."
The comments came in response to criticism from some Democrats and Republicans about new cost projections for the benefit. CMS officials in February said that the new drug benefit would cost more than $720 billion over its first 10 years, with expenses reaching $100 billion annually by 2015 (California Healthline, 2/24).
According to The Hill, some Republican legislators "have pointed out that it is politically difficult to make the case that Social Security is in crisis when Medicare is estimated to become insolvent 23 years before Social Security." House Majority Whip Roy Blunt (R-Mo.) during a recent House Republican Conference meeting told Rep. Zach Wamp (R-Tenn.) "that Bush's comments do not mean that changes to Medicare are off the table," the Hill reports. Wamp, who voted against the Medicare legislation in November 2003, supports means-testing for the drug benefit and legalizing prescription drug reimportation.
House Ways and Means Committee Chair Bill Thomas (R-Calif.), who opposes reimportation and "has not expressed any interest" in means-testing, also recently suggested that long-term care be considered "as part of a broad package to reform Social Security," The Hill reports (The Hill, 3/3).
CMS officials are "taking a number of steps" to ensure that beneficiaries with mental illnesses who are dually eligible for Medicaid and Medicare and who currently receive prescription drug coverage under Medicaid will experience a "smooth transition" into the new Medicare law's Prescription Drug Plans, CMS Administrator Mark McClellan said at a Senate Special Committee on Aging hearing, CQ HealthBeat reports.
Under the new Medicare law, about 6.5 million beneficiaries as of Jan. 1 will no longer receive drug coverage through Medicaid and will be automatically enrolled in PDPs. McClellan told committee members that PDP enrollment will begin three months before dual eligibles are transferred to Medicare, Medicaid will cover prescription drugs for former beneficiaries for up to 90 days from when they were transferred and a beneficiary will not be required to show a pharmacist evidence of PDP coverage on Jan. 1, 2006, to receive a prescription.
McClellan also noted that a physician or patient can file an appeal if a certain prescription is not included on a PDP formulary.
Some advocates have said that an insufficient transition "could in some cases literally result in homelessness, destitution, prison or even suicide" for some beneficiaries, according to CQ HealthBeat (CQ HealthBeat 3/3).
Tina Kitchin, medical director of the Oregon Department of Human Services, said that because dual eligibles will be randomly assigned to PDPs, the process could "maximize the chances that a beneficiary is enrolled in a plan that does not meet their needs." She added that because a high proportion of dual eligibles have cognitive impairments, such as dementia or mental illness, tools designed to help residents, such as the Medicare Web site or toll-free Medicare hotline, will be "irrelevant."
Carl Clark, CEO of the Mental Health Center of Denver, added that he has "very serious doubts" about the drug benefit enrollment process for dual eligibles, saying that even a short disruption in beneficiaries medication regimens could leave them "destitute, homeless or in state prison" (Rovner, CongressDaily, 3/4).
Senate Special Committee on Aging Chair Gordon Smith (R-Ore.) asked Clark to keep him apprised of transition problems (CQ HealthBeat, 3/3).
Federal Reserve Chair Alan Greenspan's comments to the House Budget Committee on Wednesday were a "brief lesson in reality based arithmetic," a Washington Times editorial states (Washington Times, 3/3).
Greenspan told Congress that Medicare is a much larger problem than Social Security because health care costs are difficult to predict, and Congress should consider possible benefit cuts in Medicare "sooner rather than later." Greenspan said that unless growth in both programs is curtailed, Medicaid and Medicare spending will increase from 8% of the gross domestic product in 2003 to 13% by 2030 (California Healthline, 3/3).
"In his understated way," Greenspan "let the committee know what the likely results of business-as-usual U.S. budget policy would be ... [a]nd he didn't hide his contempt for such policymaking," the editorial concludes (Washington Times, 3/4).