Michaud says Medicare Rx drug bill a ‘sham’

Maine’s two Democratic congressmen say the new Medicare prescription drug benefit is too complicated for many older Americans to understand and fails to offer consistent, meaningful savings.

U.S. Reps. Tom Allen and Michael Michaud have introduced federal legislation to amend the Medicare Modernization Act of 2003 to provide a competing drug benefit – a proposal they say is much simpler and will offer seniors less expensive drugs. If the elderly take their medications, their health will improve and the overall cost of health care will go down, they say.

In an editorial board meeting Thursday at the Bangor Daily News, Michaud and Allen described a federal drug benefit that would require the taxpayer-funded Medicare program to offer its own prescription drug discount card and, beginning in 2006, a federal coverage plan that uses the aggregate buying power of Medicare’s roughly 40 million enrollees to negotiate steep discounts from drug manufacturers. Savings achieved through these negotiations would be passed directly on to consumers in the form of significantly lower prices and more comprehensive coverage, the congressmen propose.

“People who take the time to read [the existing Medicare prescription bill] realize it’s a sham,” said Michaud, who represents Maine’s northern 2nd Congressional District. “The discount cards aren’t working. People are finding it too confusing and that it doesn’t provide enough of a benefit.”

Allen said the passage of the prescription benefit for older Americans was seen as “a great victory” by Republicans, but that support for the plan has dwindled dramatically. “It’s got to be changed,” he said.

The Medicare prescription drug benefit, the Bush administration’s solution to out-of-reach drug prices for American seniors, is just over 4 months old. But Maine health officials say participation has been light in the first stage of the plan, in which Medicare participants may sign up for a temporary drug discount card available through dozens of private companies. In January 2006, the cards become obsolete, and participants will be able to purchase “Medicare Part D” to provide coverage for their medications.

Cards from about 40 different companies are currently available to Maine residents. Each covers a different set of drugs and offers a different level of discount. Both the drugs and the discount can change at any time, although enrollees can only change cards once. Not all cards are accepted at all pharmacies. Some companies charge an enrollment fee, others do not. Most offer a maximum discount of 15 percent to 20 percent off the retail price of the drugs they cover.

Proponents of this system say it offers a range of options so consumers can select the card that best meets their needs. And many seniors have realized important savings by choosing the right card.

But consumer advocates say the complexity of sorting through those options is discouraging many seniors from signing up at all. Since the bill specifically prohibits the Health and Human Services secretary from negotiating lower prices with drug manufacturers, critics complain that manufacturers can simply raise prices at will and continue to make huge profits off the elderly. And critics say the companies that offer the discount cards will prosper, too, because they are not required to divulge deals with drug companies or pass on savings to consumers.

At the Eastern Agency on Aging in Brewer, one of several offices charged with helping seniors understand the complicated process of selecting a card, director of community services Deborah Chapman said just one application has been completed and filed by agency staff since the card program was introduce on May 1.

Chapman said many elders have requested information, and some have no doubt navigated the selection process themselves or with the help of family or friends. And, she noted, nearly 6,000 of Maine’s lowest-income seniors were automatically assigned to one particular discount card plan as a result of their participation in a state drug program called Drugs for the Elderly and Disabled, or DEL. DEL provides low-income elderly and disabled Mainers an average 80 percent discount on some drugs.

But other than the DEL population, state officials say participation here has been low, although real numbers are not yet available.

“It does seem like the turnout has been light in terms of enrollment,” said Mary Walsh, manager of community programs at Maine’s Bureau of Elder and Adult Services. Walsh said her office has worked with agencies throughout the state to educate seniors about their options and help them select a card. But many low-income older Mainers feel they get a better deal with DEL or another state program called Maine Rx Plus, which provides up to 60 percent off generic medications.

“A lot of people are confused by the number of Medicare cards available, and some just don’t think they need a card,” Walsh said.

Roseanne Pawelek, a spokeswoman at the Boston regional office of the Center for Medicare and Medicaid Services, said the federal agency has not yet compiled state enrollment data, but the information would be available later this month.

Maine’s “generous” drug programs have discouraged enrollment in the federal program, she said, but there are many Mainers who would benefit by participating. Nationwide, she said, about 4.3 million Americans have signed up for a drug card, roughly half the targeted 7.3 million the government hopes to have signed up by December.

Pawelek said Mainers should visit www.Medicare.gov or call 1-800-Medicare for help in selecting a Medicare drug discount card.