Charleston Gazette: ‘Jay aims to fix ‘disastrous’ Medicare drug benefit’

'Jay aims to fix 'disastrous' Medicare drug benefit'
The Charleston Gazette (WV)
By Paul J. Nyden
Jun 4, 2006 (Knight Ridder/Tribune Business News delivered by Newstex) --

Sen. Jay Rockefeller is working to pass legislation to protect health benefits of senior citizens under Medicare.

Rockefeller, D-W.Va., praised West Virginians United, a coalition group that held a meeting in Cross Lanes last Wednesday to talk with seniors about changes needed in federal Medicare prescription benefits.

"I have heard from seniors and individuals with disabilities throughout the state who are frustrated and confused by the 52 prescription drug plans available in West Virginia," Rockefeller wrote in a letter to the coalition.

"I have also heard from seniors who are going without their necessary medications because they cannot afford the Medicare premiums and co-pays or because they missed the May 15 open-enrollment deadline," he wrote. "It is unacceptable that a program sold as offering so much help is causing so much harm."

Recent legislation, backed by the Bush administration, required Medicare recipients to choose, and sign up for, a specific drug plan by May 15. The choices have often been confusing, seniors and their advocates say.

"Unfortunately, many in Congress -- with the support of President Bush -- passed a bill that put drug companies and insurance companies ahead of seniors," Rockefeller wrote. "Our seniors continue to pay the price for that decision."

Rockefeller and Sen. Ben Nelson, D-Neb., repeatedly tried to get the May 15 deadline for enrollment extended for six months. They also support legislation that would eliminate all penalties that will be charged seniors who sign up for plans in November.

Rockefeller also believes Medicare recipients should have the opportunity to switch plans during the year.

Most low-income seniors have not yet gotten special subsidies created under the new law.

On May 8, Families USA, a liberal health advocacy organization, published a report revealing that just 24 percent of 7.2 million seniors and disabled citizens, often minorities, eligible for low-income subsidies had actually been approved to get those subsidies.

Participation rates ranged from 12 percent in Arizona to 41 percent in Kentucky. West Virginia's rate was 21 percent, according to Families USA.

Research done by Rockefeller's office showed the Social Security Administration is slow in processing applications, often requiring low-income people to wait eight or nine months to get decisions.

"Yet the Republican-controlled Congress refuses to hold formal hearings and address the reality that this new program has been disastrous for many seniors and individuals with disabilities," Rockefeller wrote.

Negotiations with drug companies also could reduce rates for seniors.

In March, Rockefeller and eight other senators introduced the Medicare Prescription Drug Gap Reduction Act to allow the secretary of health and human services to negotiate with pharmaceutical companies for lower drug prices.

Today, the Veterans Administration routinely negotiates with pharmaceutical companies over prices of drugs.

But since federal law bars Medicare from similar negotiations with pharmaceutical companies, seniors often pay up to 50 percent more than veterans pay for the same drugs.

Rockefeller's bill would also dedicate any money saved through negotiations with drug companies to plug up the "donut hole" -- part of the new payment system for pharmaceuticals bought by seniors on Medicare.

In addition to monthly Medicare premiums ranging from $25 to $34, seniors pay all prescription drug costs up to the first $250, then 25 percent of all costs between $251 and $2,250.

Then seniors get hit with 100 percent of all their drug costs between $2,251 and $5,100 -- what's called the "donut hole."

Only when their annual drug payments exceed $5,100 do seniors see their payment shares drop to 5 percent.

During the current controversy, the AARP seniors lobby has never criticized the Bush administration for punishing seniors who failed to meet the May 15 deadline.

AARP is among the private companies and organizations that offer seniors prescription drug plans of their own.

To contact staff writer Paul J. Nyden, use e-mail or all 348-5164.