American seniors are starting to get a handle on just how badly they've been screwed by the Bush Medicare Prescription Drug privatization plan:
Welcome to 2006, when millions of older Americans will be falling down the doughnut hole, searching for new adventures in Medicareland, where things are "curiouser and curiouser."
Despite the pleas of 43 million Medicare beneficiaries for a prescription drug benefit, the federal Centers for Medicare and Medicaid Services says less than
5 percent (1 million) of the 21 million eligible Medicare beneficiaries with little or no drug coverage had enrolled in a Part D prescription drug plan as of Jan. 1.
In a misleading announcement that was close to a lie, CMS said that 21 million Medicare beneficiaries now have drug coverage. But 20 million already had coverage from former employers, the VA, their HMOs and other sources. That means 95 percent of Medicare beneficiaries who need coverage have yet to decide whether and how to enroll. During the first 11 months after passage of original Medicare in 1965,
93 percent of those eligible had enrolled.
No one knows yet how many of the 6.4 million "dual eligibles," poor or disabled Medicaid beneficiaries also eligible for Medicare, were automatically switched from Medicaid to Part D on New Year's Day, as the law required, without missing their vital medicines. My guess is that thousands of the sickest and most vulnerable people were not successfully switched and will be desperate for their medications. But CMS, at the Department of Health and Human Services, has not figured out what to do to tide over such people. After the dual eligibles are switched, they can choose their own drug coverage. Although Part D is supposed to be voluntary, if a dual eligible does not enroll in Part D, he or she would lose Medicaid coverage for other health services.
To make matters worse, a dual eligible's family could lose all their retiree coverage without knowing it if he or she is automatically signed up for Part D. Many of those beneficiaries are in nursing homes. Again, if your family is getting retiree health coverage, check with your former employer and, if necessary, quit Part D.
Vicki Gottlich, a Washington attorney for the Center for Medicare Advocacy, along with the National Senior Citizens Law Center and the Medicare Rights Center, has asked Congress and CMS to delay the May 15 deadline for enrolling through the end of 2006, and to delay or abandon penalties for signing up after the deadline, to give the program time to work out the worst kinks.
They told Medicare: "This situation has a particularly severe impact on dual eligibles who are auto enrolled in Part D and whose spouses count on their retiree benefits for all health coverage.... Employers have no obligation to inform their retirees and current employees about the loss of health benefits."
Gottlich said there may be an effort when Congress reconvenes to relax restrictions on getting extra help for about 2 million poor, non-Medicaid beneficiaries whose income is below the limits ($12,920 for a single person and $17,321 for a couple) needed to qualify for low-cost benefits but whose savings are too high. The savings limits are $11,500 for an individual and $23,000 for a couple.
But Gottlich doubts this Congress or President George W. Bush will deal with the fundamental reason for these problems. As correspondent Margaret Warner said recently on PBS' "NewsHour," "There's no standard government-designed plan" administered by Medicare. "Instead, enrollees have to choose from dozens of plans offered by private insurance, with different deductibles, co-pays and lists of authorized drugs."
Some Democrats want to modify the privatization aspects of the law by having at least one standard plan run by Medicare. But that would mean competition for private companies from the more efficient Medicare system, which could use its purchasing power to drive prices down. The Republicans and the drug companies who bought them won't hear of it.
More here.
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