HHS Leader Promotes Medicare ‘Part D’ Benefit: U.S. Has Been Slow to Adopt Drug Program

By Jeremy Olson, Pioneer Press, St. Paul, Minn.

Apr. 6–The nation’s top health care official visited the Twin Cities on Wednesday to promote Medicare’s new prescription drug benefit for seniors and the disabled — a program that so far has drawn less interest than anticipated.

The 2006 enrollment deadline is 39 days away, and so far 18 million people have signed up for Part D plans. U.S. Health and Human Services initially estimated 29.3 million enrollees in the first year. HHS Secretary Mike Leavitt said during a visit to a Brooklyn Center library that he wasn’t worried about low enrollment, but encouraged seniors to avoid the last-minute rush.

“We’re worried they’ll put it off until the last days before the deadline,” he said. “Things could get kind of tough.”

Leavitt’s visit is part of a second wind of marketing for Part D, which is provided through private insurance companies. New radio and television ads remind people of the May 15 deadline. A March survey by the Medicare Rx Education Network, which promotes Part D, also suggests that 87 percent of seniors are satisfied with their drug plans.

Many seniors had no drug coverage before Part D and either paid for drugs out-ofpocket or rationed their prescriptions to keep them affordable.

Low enrollment could be a problem, especially if the only people who sign up have high drug costs, said Dan Mendelson, president of Alavere Health, which conducts health policy research and analysis. In that case, some insurers will either have to raise premiums or drop out of the Part D market. That will reduce the competition among insurers that helps keep costs down.

“Many of the plans that set out into this market, set out with expectations that they would have a larger base of beneficiaries,” said Mendelson, a former Clinton administration budget official. “I do expect you will see some of the smaller, newer plans dropping out.”

Part D’s financial stability is dependent on seniors with low drug costs enrolling as well. One incentive for these seniors is that Medicare will charge premium penalties if they don’t enroll this year or secure comparable drug coverage through an employer or other government program. Federal officials have also tried to lure these low-cost seniors by promoting how Part D will protect them if their drug costs escalate.

“The important thing that I’m noticing among seniors is that they’re getting peace of mind knowing that their savings aren’t going to be wiped out because of prescription drugs,” Leavitt said.

The secretary’s remarks came as workers with the state’s Senior LinkAge line counseled seniors at the library about which Part D plans might work best for them. The Part D plans offered in Minnesota differ widely in their premiums — from less than $2 to more than $99 per month — and also in the drugs they cover and the deductibles and other copays they charge.

President Bush and Medicare’s chief administrator, Dr. Mark McClellan, also promoted Part D in Minnesota last year. This is Leavitt’s third trip in Minnesota since December. The last two focused on bird flu. Wednesday’s visit was delayed, briefly, because two bomb-sniffing dogs had reacted to a car in the library parking lot. No bomb was found.

HHS estimated 39.1 million people would enroll this year in Part D or comparable plans, but Leavitt said Wednesday that his goal is 28 million to 30 million people. Health policy analysts have questioned whether this new estimate is an attempt to make enrollment levels look better.

Minnesotans have been slow to enroll in Part D but appear to be catching up. March 18 figures showed that 62 percent of Medicare enrollees in the state had prescription drug coverage through Part D or comparable plans. The national figure was 64 percent.

Insurers reported mixed success in meeting enrollment goals. Cigna, for example, has nearly halved its expectations based on the number of individuals who have signed up. The company has reported success, though, in providing group coverage through employers, who receive federal subsidies if they offer drug benefits to retirees.

Startup problems have hampered Part D in its first months. Some enrollees couldn’t get drug coverage right away, which was especially a problem for low-income seniors who previously received drug coverage through state Medicaid programs.

Politicians opposed to the privatization of Part D have seized on the startup problems, and their criticisms haven’t helped enrollment, said Phil Blando of the Pharmaceutical Care Management Association. Enrollment is picking up as the deadline nears, though, he said.

Confusion remains among seniors. Harriet Butchko, 90, of Lakeland, said she signed up for something related to Part D earlier this year. She hasn’t received any enrollment documents in the mail, though, other than daily Part D advertisements.

She could use help with her $30 to $40 in monthly drug costs, which increased this month when she said she spent $120 on antibiotics.

“I pay for prescriptions when I can,” she said, “and if I can’t afford it, I don’t.”

Jeremy Olson can be reached at jolson@pioneerpress.com or 651-228-5583.

FYI

Need Part D help? The Senior LinkAge line at 1-800-333-2433 will assist seniors in selecting plans that cover their drugs and fit their budgets.

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Copyright (c) 2006, Pioneer Press, St. Paul, Minn.

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