The new Medicare drug program signed up about 1 million new enrollees in its first month of enrollment, federal officials announced yesterday, touching off a debate about whether that represented success or signaled confusion over the new benefit.
The number represents a fraction of the 8 million to 10 million people federal officials are expecting to enroll by May 15, the deadline to sign up without paying a penalty.
Michael O. Leavitt, secretary of health and human services, announced a total enrollment of 21 million as of Dec. 13. That includes about 14 million who will continue to get benefits from private and federal programs and from Medicare HMOs; those programs will get a subsidy from Medicare for drug coverage.
Some had predicted many employers would drop coverage, but federal officials said more than 90 percent of retirees in private plans would continue to receive their previous benefits or improved coverage. Another 6 million have been automatically switched over to Medicare drug plans from state-run Medicaid programs.
"This is a very good start," Leavitt said at a news conference. "We're on track to reach our goal of 28 to 30 million."
But others said the start wasn't good at all.
"They're claiming a triumph with 21 million covered, but 20 million of them had coverage before," countered Robert M. Hayes, president of the New York-based Medicare Rights Center.
"We hope program enrollment improves significantly," said Ron Pollack, president of Families USA, a Washington consumer group. "But it seems likely that the confusing and bewildering structure of the new Medicare drug program will continue to hinder that progress."
Seniors interviewed this week at senior centers in the Baltimore area generally said they are still considering their options - and that the options aren't very clear to them.
"I've been getting all kinds of literature, and I have to wade through it," said Mario Mogavero, 86, who lives in the Charlestown retirement community. "Somebody's going to have to show me which plan is best."
"My daughter does everything for me," said Leona Buckingham, 88, of Arbutus. She fished from her purse a prescription discount card she got this year, but said she wasn't sure whether that would be good after the new benefit begins Jan. 1. Like Mogavero, she was interviewed at the Catonsville Senior Center.
Christine Shanks, 53, of the Oliver neighborhood in East Baltimore, was at the Oliver Senior Center Wednesday trying to find out about enrollment for her mother, Lillian Shanks, 86. She was being counseled by Julie Caler, a doctoral student at University of Maryland School of Pharmacy.
The younger Shanks said she found the names of the 47 plans confusing, and help hard to find. "Unicare, United Care. Advantage, Advantix. I've been calling Medicare, but I can't get through. They got that www-dot-Medicare, but how many people have got computers?"
She said she had attended several information sessions, but that some part of the process, including actual sign-up, couldn't be done without her mother, who sometimes isn't well enough to come along.
"In two different instances, I had to go home and get her," she said.
Sign-up began Nov. 15. Seniors and people with disabilities can choose from a wide array of private prescription insurance plans, each with a different monthly premium, different list of covered drugs, different co-payments, and different rosters of participating pharmacies.
For those who sign up by the end of this month, benefits begin Jan. 1.
Hayes said Congress needed to revamp the program, which he said was too complex. "There's such a degree of frustration and bewilderment," he said.
Mohit M. Ghose, vice president of public affairs for America's Health Insurance Plans, a trade group, said the profusion of plans worked for the benefit of consumers.
"You can see the effects of competition in the system, where the beneficiaries win, and they are saving more money than was forecast," he said, noting that monthly premiums are averaging $32, compared to an expected $38.
Those involved in education and enrollment say they've gotten lots of interest, but that it hasn't necessarily translated into enrollments.
Pat Venable, coordinator for the Senior Health Insurance Assistance Program for Baltimore County, said the county Department of Aging had conducted 163 presentations in churches, senior centers, housing for the elderly and other locations, reaching about 7,000 people. But when the office conducted signup assistance days at three locations in the county, only about 150 people enrolled at each.
"It's important to stay positive," she said. While the choices may seem confusing, "it really is a good program" that will help many seniors cope with the costs of prescriptions.