Posted At M&C News
BY : Todd Zwillich
Experts warned Monday that access problems plaguing Medicare`s new prescription drug benefit will continue unless Congress makes changes to the program.
The comments came during a hearing convened by Senate Democrats, who have criticized the benefit, known as Medicare Part D, and are vowing attempts to alter some of its more unpopular features.
As many as 600,000 low-income seniors were over-charged for prescriptions or denied benefits when their drug coverage was automatically switched from Medicaid to Medicare on January 1.
The Bush Administration blamed computer problems and agreed to reimburse more than 40 states for the cost of emergency medications given to seniors.
Medicare officials said last week that private health plans have cut the problems by about two-thirds. But witnesses told the committee that Part D`s design will continue to cause problems for low income seniors.
Tim Westmoreland, a professor at Georgetown University`s Health Policy Institute, said that 'dual eligibles'--seniors who qualify for Medicaid and Medicare--will continue to face delays as they transition each year from Medicaid`s state-run rolls to private formularies carrying Medicare.
'Medicare Part D as currently constructed guarantees a never-ending transition,' he said.
Democrats have also attacked the Republican-authored program for offering too many plans to seniors. Beneficiaries are asked to choose between 40 or more competing plans with varying premiums and amounts of coverage.
President Bush used part of his weekly radio address Saturday to defend the program. More than 25 million people with Medicare now have prescription drug coverage, and hundreds of thousands more are enrolling each week,' he said.
Approximately 5.4 million seniors have enrolled who did not already have drug coverage through an employer or the government, according to federal figures released last week.
Health and Human Services Secretary Michael Leavitt told reporters last week that market competition would eventually 'shakeout' some poorly-performing plans from the system.
Westmoreland warned that the expected shakeout would force some seniors already in Medicare back into a maze of plan selection.
'Any (beneficiary) enrolled in disappearing plan will have to start over,' he said.
The hearing came on the heels of a week-long congressional recess which Democrats used to hold events throughout the country criticizing the new Medicare plan.
Democrats hold a public opinion advantage over Republican on Medicare and other health issues, and have vowed to push legislative changes to the program.
One amendment would extend a May 15 sign-up deadline until the end of 2006 for seniors who are confused by multiple plan choices.
'That ought to be the first baby step that Congress takes,' said Sen. Byron Dorgan, D-N.D., chair of the Democratic Policy Committee, which called Monday`s hearing.
Democrats also enjoy limited bipartisan support for an effort to repeal a part of the Medicare law barring the federal government from negotiating with drug makers for lower medication prices.
A coverage gap mandated by Congress cuts off benefits between $2,250 and $5,100 in personal drug spending, in an effort to control Part D`s costs. Gerard Anderson, a health policy professor at Johns Hopkins University and a former Medicare official, told lawmakers that the so-called coverage 'donut hole' is needed because prices remain high.
'The donut hole could be completely eliminated if the United States paid the same as Canada, the United Kingdom, or France' for drugs, he said.
In an interview, Dorgan said that there was 'no question' that Democrats try to amend the drug plan during the coming election year. 'If the administration continues to insist that it will not make any changes, should that be an issue in the political system? Should that be a political issue? The answer is, `yes`,' Dorgan said.
Jim Manley, a spokesman for Senate Minority Leader Harry Reid, D-Nev., said that lawmaker could offer amendments on bills 'within weeks.'
