The Senate rejected an effort by Democrats on Thursday to give older Americans and the disabled more time to enroll in Medicare’s prescription drug benefit.
Sen. Bill Nelson, D-Fla., offered an amendment to tax legislation that would have given Medicare beneficiaries until Jan. 1 to enroll without penalty. The current deadline is May 15.
The amendment also would have allowed people to switch their prescription drug coverage to another plan if they were unhappy with current coverage.
The amendment received a majority of votes, 52-45, but needed 60 to pass under Senate rules for measures concerning budgets and taxes. Nelson said his amendment was a chance for lawmakers to act on complaints they’ve heard from their constituents since the program began Jan. 1.
But Sen. Charles Grassley, R-Iowa, said the legislation was unnecessary. He said passing a bill would only cause delays in solving problems that can be dealt with administratively by Health and Human Services Secretary Mike Leavitt.
At a hearing on the problem earlier Thursday, Nelson told fellow lawmakers of seeing elderly people weep as they described difficulties in filling their prescriptions.
Sen. Blanche Lincoln, D-Ark., said she’s heard from three pharmacists in her state who have had to take out loans because they could not get reimbursed quickly enough for drugs dispensed to customers who had no means to pay them. Sen. Hillary Rodham Clinton, D-N.Y., said she was tired of hearing how so many people were signing up. Many people in the program already had coverage, she said.
“I for one believe we should scrap this and start over,” Clinton said.
Republicans also said they had heard from people who have had difficulty filling prescriptions, or being charged more than they should have been, but they told Mark McClellan, head of the Centers for Medicare and Medicaid Services, that the program should be fixed, not scrapped.
“It is nearly impossible to avoid startup challenges, but we now we must identify those individuals who are vulnerable and make certain that their needs are met,” said Sen. Elizabeth Dole, R-N.C.
McClellan said the government makes “no excuses for the problems. They are important, they are ours to solve and we are finding and fixing them.”
The Bush administration had asked private insurers to supply older people with an additional 60-day supply of medicine in emergency cases.
That will give beneficiaries more time to find alternative treatments when their plan will not cover a prescription or more time to file an appeal. Pharmacists had warned that the previous 30-day limit could pose significant problems for poor older people and the disabled.
The program is working for most people, McClellan said, and competition among the private plans was driving down costs.
Premiums will average about $25 a month, as opposed to the $37 projected when the program was approved. McClellan’s agency now estimates the program will cost about $678 billion over 10 years rather than about $730 billion.
Leavitt, in an earlier interview, said, “We’re seeing the cost of drugs come down in a rapid way because of an organized, competitive marketplace.”
McClellan told the Senate Special Committee on Aging that the new cost estimates reflect people’s choice of plans that offer the lowest premiums.
The most critical assessments of the program came from Democrats. When McClellan said the agency was trying to make the program “even easier” to understand, Sen. Ron Wyden, D-Ore., said: “Even easier? It’s bedlam out there.”
About 42 million older people and the disabled are eligible to participate in the drug benefit. They do so by enrolling in a private insurance plan. The benefit should lower drug costs for most participants because the government is subsidizing their drug costs.
Dozens of states have stepped in, temporarily paying for medicine that beneficiaries have been unable to get through Medicare. McClellan said the government would work to make sure that private plans reimburse the states.
The most serious concerns about the benefit center on the 6 million low-income people who had obtained drug coverage through Medicaid. In the transition to Medicare, a few hundred thousand may have had trouble because of data errors and because they switched plans late in the year, McClellan said.