Medicare Drug Benefit Enrollment Reaches Goal

CAL/AAEM News Service calaaem_news at
Sun Apr 30 22:38:33 PDT 2006

Medicare Drug Benefit Enrollment Reaches Goal

Source: California Healthline ( 
Date: April 21, 2006

More than 30 million Medicare beneficiaries now have prescription drug
coverage, exceeding the Bush administration's goal of ensuring coverage for 28
million to 30 million beneficiaries in the first year of the Medicare
prescription drug benefit, HHS Secretary Mike Leavitt said on Thursday, the
AP/Philadelphia Inquirer reports (AP/Philadelphia Inquirer, 4/21).

In the last month, 1.7 million beneficiaries enrolled in stand-alone
prescription drug plans, bringing the total number of beneficiaries with
coverage through stand-alone PDPs to 8.1 million, HHS said (Abrams, AP/Chicago
Sun-Times, 4/21). The 8.1 million total includes one million low-income
beneficiaries "who had their enrollment facilitated by CMS," HHS said.

According to HHS, beneficiaries receiving drug coverage also include:

Nearly 5.8 million beneficiaries in Medicare Advantage plans, including about
950,000 beneficiaries who voluntarily enrolled in MA plans since Jan. 1;

About 5.8 million dual eligibles who were automatically enrolled in the drug
benefit and an additional 500,000 dual eligibles who were enrolled in MA plans
with drug coverage;

More than 8.2 million retirees who receive employer-sponsored drug coverage to
supplement Medicare drug benefits or who receive drug benefits through unions
or former employers that receive a subsidy from Medicare; and

3.5 million retirees who are enrolled in TRICARE -- the military health program
-- or the Federal Employee Health Benefits Program.
Separately, more than 5.8 million beneficiaries receive drug coverage through
the Veterans Administration or other sources with coverage at least as good as
Medicare, bringing the total number of beneficiaries with drug coverage to
about 35.8 million, according to HHS (HHS release, 4/20).

Comments From Bush Administration
Leavitt said that 90% of the estimated 43 million Medicare beneficiaries will
have prescription drug coverage by the May 15 enrollment deadline if sign-up
rates continue at the same pace (AP/Philadelphia Inquirer, 4/21). Leavitt and
CMS Administrator Mark McClellan said about three million beneficiaries who
have not enrolled qualify for a low-income subsidy. "That's a very hard
population to reach," McClellan said (Mussenden, Richmond Times-Dispatch,

Leavitt and McClellan also reiterated that the administration does not support
an extension of the enrollment deadline, a move urged by some lawmakers who
have pushed for legislative action on the matter.

Leavitt said, "The deadline is a very important part of this. It helps seniors
focus on this, and it's working" (Carey, CQ HealthBeat, 4/20).

McClellan said Medicare actuaries estimate that two million fewer beneficiaries
would sign up for the benefit by May 15 if the deadline were extended than if
it remained in place (Brand, Denver Rocky Mountain News, 4/21).

More Comments
Rep. Pete Stark (D-Calif.) said in a statement that the administration
projected in December 2003 that 40.7 million beneficiaries would receive
coverage under the drug benefit, adding, "Despite President Bush's
cross-country dog and pony show, millions of seniors have yet to sign up for a
prescription drug plan."

Robert Hayes, president of the Medicare Rights Center, said the numbers show
that more than 80% of the lowest-income beneficiaries have not been enrolled in
the Medicare drug benefit and that "less than 20%" of beneficiaries overall
have "new drug coverage" (CQ HealthBeat, 4/20). Hayes added administration
officials do not want to extend the enrollment deadline because "[t]hey want to
maximize the pressure," noting, "[C]ome May 15th, if the enrollment remains
low, that may well be when the president says, 'let's extend it'" (Richmond
Times-Dispatch, 4/21).

Dan Mendelson -- president of Avalere Health, a health care consulting firm --
said relatively healthy beneficiaries have not enrolled in the benefit in large
numbers because they think they do not need it, adding, "Those are really the
people you have to worry about" (CQ HealthBeat, 4/20).

Enrollment Estimates
In related news, the Wall Street Journal on Friday examined how the number of
beneficiaries who are "actually enrolled" in the drug benefit is lower than 30
million, "[d]espite the headline on an [HHS] press release -- '30 million
Medicare beneficiaries now receiving prescription drug coverage.'" The 30
million estimate includes 3.5 million individuals who receive coverage through
TRICARE or the FEHB Program, "but aren't signed up for the Medicare benefit,"
meaning about 26.5 million beneficiaries currently are "benefiting from the
Medicare drug program," the Journal reports.

Of that total, 5.8 million previously had drug coverage through Medicaid and
were enrolled automatically, and an additional 6.8 million receive drug
coverage through their former employer, who receives subsidies from Medicare.

HHS spokesperson Christina Pearson said all beneficiaries "were able to make
the choice that works best for them" because of the new drug benefit,
regardless of their source of coverage.

Some critics of the drug benefit have said the administration has revised its
enrollment goals since the program was created or otherwise altered the
enrollment count to meet projections, the Journal reports.

However, Pearson said, "We've consistently said our goal was 28 to 30 million,
[a]nd by any measure we've surpassed that goal" (Lueck, Wall Street Journal,

For more information, please visit:

Cyrus Shahpar & Brian Potts 
Managing Editors, CAL/AAEM News Service
University of California, Irvine

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