Confusion remains as drug-plan deadline nears

The government's Centers for Medicare & Medicaid Services (CMS), which runs the drug benefit program, seems to be listening. Last week, CMS administrator Mark McClellan said that each drug-plan provider would be limited to offering only two plans next year. This year each company could offer three different plans.

The CMS has been scurrying to answer seniors' questions and urging them to join before the May 15 deadline. Just one of its initiatives has been a $30 million program in which it teams with state agencies to contact potential enrollees.

In a drug benefit progress report released last week, Mike Leavitt, the secretary of Health and Human Services, noted that more than 27 million eligible seniors have been signed up, not far short of the CMS goal of 28 million to 30 million by May 15. About 42 million Americans would qualify for the drug benefit. In addition, Secretary Leavitt said waiting times on the 1-800-MEDICARE telephone help line have been reduced from about 4-1/2 minutes in January to just 28 seconds in mid-March.

The cost to participants has been lower than expected, too. CMS had estimated that the average enrollee would pay about $37 per month. Instead, the average premium has been about $25 per month, he said, with some people paying less than $2 per month. One private study, the progress report said, showed seniors without any current drug coverage would see their annual drug costs drop from an average of $1,905 today to $626.

A new survey offered more good news. Nearly 4 out of 5 people (78 percent) who voluntarily signed up for the Medicare drug benefit are satisfied with their coverage, according to the Medicare Rx Education Network, a broad coalition of healthcare organizations. A majority (58 percent) reported it was not difficult to sign up for a plan. But 38 percent said it was difficult, and 82 percent said they would advise others to get help in choosing a plan.

The transfer of vulnerable "dual eligible" citizens particularly has bothered Robert Moffit, director of the Center for Health Policy Studies at The Heritage Foundation, a conservative Washington think tank. "We begged Congress not to do this, to just leave these people alone," he says. "They insisted on coercing them into the new drug program. So for all of the talk about personal freedom and choice, that's garbage. Those people were forced into the Medicare program regardless of their wishes on the matter." The transfer, he says, "turned out to be a big nightmare at the state level."

In the long term, Medicare Part D is going to be "a fabulously expensive drug benefit," Mr. Moffit predicts. "It was a stunning act of fiscal irresponsibility by the Republican leadership in Congress."

People may like their plan now, but he warns of a "doughnut hole" in the coverage. After a participant and his plan provider combine to spend $2,250 on drugs in a given year, the provider doesn't pay anything again until $5,100 has been spent. A Heritage Foundation study predicts that many participants will hit this "doughnut hole" next fall - and perhaps change their minds about the plan - just in time to vote in congressional elections.

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