Since last summer, Diane Silva had been trying to persuade her mother to sign up for one of the new Medicare prescription plans.
With the enrollment deadline hours away yesterday, she finally got her mother to attend the "Medicare Marathon" sponsored by AARP at Reisterstown Road Plaza, joining thousands nationwide rushing to get in under the wire.
By the time the two had finished, Laura Silva, 86, of East Baltimore was signed up for the Part D prescription plan, which she thinks will save her about $350 a year on her three medications.
"That's pretty good," she said, smiling.
With yesterday's midnight deadline looming, state and local governments, federal officials, advocacy groups such as AARP, insurers and pharmacies staged a final push yesterday to sign up the estimated 6 million people (critics of the plan say the number could be higher) without drug coverage who had not enrolled. An additional 9 million, including people with disabilities, had signed up by last week.
Those who missed the deadline - with some exceptions - won't have another chance until a new enrollment period begins Nov. 15, and they will then face a penalty of 1 percent of the average premium for each month they delay, which means about $2 a month tacked onto premiums for those who delay until fall.
Amid growing political pressure to extend the deadline or waive the penalty, the Bush administration was noncommittal yesterday on whether it would soften the rules.
"I'm not going to give you a categorical answer," White House spokesman Tony Snow said. "The deadline's the deadline," he said.
The deadline dispute is the most recent of many over a program - which the Medicare agency estimates will cost $797 billion over the next decade - that has been hotly debated since Congress narrowly passed it in 2003. The program has been criticized for being too complicated, for relying on private insurers and for leaving gaps in coverage.
Some of the harshest criticism has centered on what many see as a dizzying array of plans - there are 47 in Maryland - each of which covers different medications, uses different pharmacies and has different premiums and out-of pocket costs.
Problems surfaced when enrollment began in the fall, especially for people who had been getting benefits under state Medicaid programs and were automatically switched over to the new plan.
When coverage began Jan. 1, some states started emergency programs to pay for drugs for enrollees who hadn't shown up on the Medicare computer.
Those problems have eased considerably, but many people have continued to complain that finding a program covering specific medicines at the lowest cost from a convenient pharmacy was too bewildering, leaving millions not signed up as the deadline approached.
The Woodlawn-based Centers for Medicare and Medicaid Services, the federal agency that runs Medicare, said yesterday that it was fielding hundreds of thousands of calls. Those who called before the deadline but were put on hold could leave their names and numbers, and will be called back within the next few days to enroll without penalty, said Lorraine Ryan, an agency spokeswoman.
On Friday, 72,000 people enrolled online, triple the number sho had enrolled the previous Friday, Ryan said.
The agency received an average of more than 300,000 calls a day last week, up from 140,000 two months ago.
By today, Ryan said, her agency hopes to have a better idea when the final enrollment figures will be compiled.
In the Baltimore area, agencies on aging scrambled to answer phone calls and provide one-on-one counseling.
In Anne Arundel County, Susan Knight's staff at the Anne Arundel Senior Health Insurance Program had fielded 60 phone calls, scheduled 30 appointments and had numerous walk-ins yesterday, with five hours to go.
Knight, director of the agency, said a number of people were still confused and added, "You don't want to have all those question marks out there on the last day."
CareFirst BlueCross BlueShield, the state's largest insurer, which is offering two Part D plans, said it received twice as many calls as usual yesterday. Like CareFirst, other insurers said they had expanded their staffs to handle the expected volume.
Not all events were swamped.
Seven people signed up in Carroll County, said Debbie Frame, senior information and assistance supervisor for the Carroll County Bureau of Aging.
"I expected a lot of people knocking on the door saying, `Please help me,' but we didn't," Frame said.
By 1 p.m. yesterday, eight people had gone to the Embassy Suites Hotel in Hunt Valley looking for assistance with their prescription plans at a morning-to-midnight session sponsored by the Maryland Senior Prescription Drug Assistance Program.
Richard Popper, executive director of the program, which offers state premium subsidies to moderate-income seniors, said his agency had mailed out 5,000 fliers to remind people about the deadline.