Posted At Billings Gazette

BY : Tom Raum

The Medicare drug program that was supposed to win political points for Republicans has exploded in their faces as this election year has begun. It's a particularly vexing problem for the GOP, since older Americans are such active voters and no one seeking office wants to see them angry.

Since the Bush administration's prescription medicine program began on Jan. 1, tens of thousands of elderly people have been unable to get medicines promised by the government. Some 20 states have had to jump in to help them.

And while officials promised anew on Tuesday that a fix was on the way, Democrats pointed to the confusion surrounding the rollout and pounded the administration and its GOP allies in Congress. Sen. Edward M. Kennedy of Massachusetts cited a "systemwide failure" that he said "puts the health of our frailest citizens at great risk." Sen. Hillary Rodham Clinton of New York likened the government's response to a "man-made disaster" to its missteps on Hurricane Katrina.

"The time for all levels of government to act is now," 14 Democratic governors said on Tuesday in a letter to President Bush.

"The political fallout is potentially enormous," said Ross Baker, a political science professor at Rutgers University. "This is a program that touches tens of millions of people. And anytime that a government program is working poorly, and is affecting adversely so many people, it's bound to have huge consequences."

Under the program, some 42 million disabled and older people are eligible to enroll in private plans that will subsidize their prescription drug costs. The sign-up period closes May 15.

The administration has pledged to persuade the insurance plans to repay those states that have jumped in to help. Many states have agreed to pick up temporarily the cost of prescription drugs for low-income seniors and others turned away at pharmacies because of confusion in the new program. The administration also told insurance companies that they must provide at least a 30-day supply of drugs to beneficiaries.

Health and Human Services Secretary Michael Leavitt said on Tuesday that some 24 million people are now enrolled in the plan and that "for the vast majority, it is working very well." But he acknowledged there were "a couple of small groups it's not working well for," including some low-income people.

The government is "working as feverishly as possible" to correct the problems, Leavitt said.

Those familiar with the program suggest the administration's figures for sign-ups are misleading.

The AARP, which supported the 2003 legislation, said more than 10 million were enrolled as part of corporate, union or government retirement plans, and 6.2 million more low-income recipients were transferred from Medicaid rolls, where many had gotten their medicines at no charge.

Voluntary enrollment "is a complicated process. It involves determining which policies serve your area and comparing prices, premiums and co-payment requirements offered by the competing plans," the AARP said in a bulletin on its Web site, www.aarp.org.

Hailed as a revolutionary advance by the administration, the program just squeaked by in the House in November 2003 after Speaker Dennis Hastert and then-House Majority Leader Tom DeLay held the vote open for nearly three hours while they pursued Republican holdouts.

The House vote reverberates in GOP politics today. Arizona conservative Rep. John Shadegg recently joined the race for House majority leader, for instance, on a platform that includes past opposition to the Medicare bill. One of just 25 Republicans to vote no, Shadegg claimed at the time that it was too expensive and would help "buy medicine for millionaires."

Republicans fear that, if the problems aren't fixed quickly, their political woes could mount, especially once enrollment closes May 15. Some Republicans, inside and outside the White House, have discussed moving back the deadline until later in the year.

Critics compare the measure to the complicated Clinton health care plan that failed in Congress and to an earlier plan passed by a Democratic-controlled Congress in the late-1980s providing catastrophic medical benefits - but requiring wealthier older Americans to pay a surcharge for them. The bill was quickly repealed.

"It's a very complicated program. I'd like to ask the president to explain it himself," said Paul C. Light, a professor of public service at New York University. "If the president and the Cabinet had to enroll, I think they might soon find out that this is a very tangled web of promises that are difficult to unravel."

And it isn't only older voters that plan supporters have to fear. "A lot of parents are getting help from their kids, many of whom are baby boomers. And they also vote," Light said.