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A Final Push for Medicare Drug Plan

Posted on: Friday, 12 May 2006, 21:02 CDT

By Jeffrey Krasner, The Boston Globe

May 12--At a Medicare drug plan recruitment event in Revere yesterday, Sharon Perpignani acted as a poster child for the disputed program.

The 54-year-old Somerville resident was introduced to reporters and officials at the Revere Senior Center by Dr. Mark B. McClellan, administrator of the Centers for Medicare & Medicaid Services and the Bush administration's chief promoter of the prescription plan known as Part D.

The benefit "is going to save me more than $3,000 a year," said Perpignani. "It's going to make a huge difference in my life. Frankly, I was skeptical, and I'm still sort of surprised. I was a doubting Thomas."

Perpignani said she has lupus, an autoimmune disease that generates a wide variety of symptoms, and takes about seven medications.

She also exemplified the frustration and difficulty many senior citizens and disabled people have experienced navigating the new drug program.

"I have a degree in physics, and it was just overwhelming to choose a program," Perpignani said. "It was just a nightmare." She said a social worker from Action for Boston Community Development, the Boston antipoverty agency, was able to guide her through the numerous options to pinpoint a plan that covered all of her medications.

The Revere event was part of a last-minute swing through New England for McClellan and other officials to enroll people in the plan before the May 15 enrollment deadline. Those who sign up for coverage after Monday will pay a penalty equal to 1 percent of the premium for every month they delay for as long as they maintain coverage.

Those who already have so-called creditable coverage -- drug coverage from a union, employer or insurer that's at least as good as the Medicare plan -- don't have to sign up and won't be affected by the penalties.

The effort is intended to get as many people to sign up for Medicare Part D as possible -- especially those who are relatively healthy and don't now need coverage to pay for medications on a regular basis.

As more healthy people enroll, insurers and drug benefit firms providing coverage will be able to spread the cost of paying for sick beneficiaries over a larger population, ensuring they can earn a profit.

Officials want potential beneficiaries to think of Part D as insurance instead of coverage: Something to buy before it's really needed.

Congressional efforts by Senator Edward M. Kennedy, Democrat of Massachusetts, and others to extend the deadline or lift the penalties appear to have failed.

The sign-up comes amid the White House's continued efforts to make Part D enrollment look successful.

McClellan said yesterday that 31 million people had enrolled in a benefit plan, while another 6 million have secured coverage through other mechanisms.

But those numbers include millions of people who already had coverage, such as disabled people receiving drugs through Medicaid, the state-federal program for low-income and disabled people.

McClellan's statistics also include millions whose coverage is not connected with the new federal program, such as military retirees and federal government retirees, who were insured before the Medicare benefit began.

McClellan warned that resources to help seniors sign up, such as 6,000 telephone representatives, will decline significantly after May 15.

Critics have focused on the program's spotty record in reaching the most vulnerable in need of drug coverage.

The Medicare Rights Center, an independent source of information on the government health program for senior citizens, said more than 80 percent of low-income people eligible for Part D benefits haven't been enrolled. The group also said this week that more than half of people with Medicare who didn't have prescription drug insurance on Jan. 1, when the benefit started, are still not covered.

"Over 6 million of the poorest Americans are still shut out from enrollment in the much heralded, sadly designed, low-income subsidy," said Robert M. Hayes, the president of the Medicare Rights Center.

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Source: The Boston Globe

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