MAY 16, 2006 -- Against a backdrop of Democratic complaints about the design and implementation of the program, seemingly exhausted but exhilarated Department of Health and Human Services (HHS) officials Tuesday sought to cast the Medicare drug benefit enrollment process that drew to a close Monday at midnight as a victory for the American people.
"It needs to be noted what a remarkable American experience this was," HHS Secretary Michael O. Leavitt told an afternoon press briefing. "The American people ought to be proud of themselves," he said, calling attention to a wide network of volunteers that helped seniors enroll in the program. "There was a network of caring that was observable during the past six months," Leavitt declared.
Centers for Medicare and Medicaid Services (CMS) Administrator Mark B. McClellan added that the enrollment process was "a historic success" and predicted that the network of thousands of volunteers and outside groups that aided the enrollment effort would stay in place to educate seniors about getting the most out of the benefit by taking prescription drugs properly, for example.
McClellan said CMS is "very confident" that "38 million plus" of the program's 43 million enrollees now have drug coverage.
McClellan noted that the most recent tally for enrollment in stand-alone Medicare prescription drug plans was about 9 million, with an added million or so signing up in Medicare Advantage plans with drug coverage since the start of the drug benefit in January. The combined sum of 10 million or so likely expanded by one million or more in the final days of the enrollment period, McClellan added.
But McClellan and Leavitt were non-committal about bipartisan legislation proposed Tuesday by Sen. Charles E. Grassley, R-Iowa, that seeks to boost the enrollment total further by waiving for the remainder of the year a financial penalty for late enrollment in the Medicare drug benefit. And McClellan expressed doubts about the method Grassley would use to pay the $1.7 billion five-year cost of dropping the penalty, namely taking money from a "stabilization fund" intended to ensure that health plans participate in the Medicare Advantage program.
Leavitt said of the proposed legislation, "There will be value in waiting to see whether or not it is needed. We don't have a lot of the facts, yet. We don't know yet what the exact number of enrollment will have been."
But Leavitt said that of the remaining 4.5 million Medicare beneficiaries without some form of drug coverage, about 3 million are eligible for low-income drug coverage for which no late penalty will be assessed. So at issue in the legislation are fewer than two million people.
"You're talking about a million and a half people or so," Leavitt said. "That'll be Congress' decision, but it might be well for them to determine what it looks like a week from now."
"When you have new legislation, you always have to find a new way to pay for it," McClellan cautioned. The administration would not want to do so by taking away from other "important health care priorities," he said. Next year Medicare Advantage plans "are going to see a much smaller increase than in the past years" — about 1.1 percent on average — "so it . . . won't be a good time to tighten down on payments to those health plans that are already saving more and more seniors a lot of money."
The two officials announced a remarkable surge of applications in the hours leading up to the midnight deadline. On Monday, more than 143,000 people enrolled online, Leavitt said, adding that "in the last few days we've had more than 500,000 online enrollments." And on Monday, he said, Medicare logged more than 640,000 calls on its 1-800 line. "There are so many people who have worked tirelessly," McClellan said. "Our staff cared about making this program work."
