MEDICARE REPAIRS

A plan by Rep. Tom Allen addresses states’ costs as a result of the rough start to the federal Medicare drug benefit, which began Jan. 1. More important than that, however, are the recommendations that begin to address some of the built-in weaknesses exposed during the opening days of the new program. Providing seniors with a drug benefit under Medicare was the right step, but the program has some shortcomings that could be fixed quickly.

The failure of the drug program for millions of seniors nationwide was apparent when those who had signed up found they had not been properly assigned to a drug plan or the plan didn’t cover their costs properly and pharmacists were unable to get through to the private insurers who had promised coverage. Nearly half of all states, including Maine, have promised to provide coverage while the system errors are repaired. Rep. Allen’s proposal, like a bill sponsored by Sen. Olympia Snowe, would ensure states are reimbursed by insurers for their costs.

Congress, however, must also sort out what in the program’s failure was the result of glitches that might be expected with any new program and what is the result of inadequate directions to insurers, overlooked demands and plain ineffectiveness.

Rep. Allen’s proposal, which he plans to introduce as legislation when the House reconvenes at the end of the month, doesn’t attempt to repair all of these areas of concern – and it shouldn’t. Medicare Part D is new and deserves time to adjust and demonstrate how well private insurers can deliver public coverage. His proposal deals more with emphasizing the kinds of coverage Congress thought was already in the Medicare bill.

For instance, the proposal would state clearly that drug plans include a minimum 30-day prescription drug supply in their transition policies and makes it easier for people who are eligible under both Medicaid and Medicare to get the proper low-priced coverage. Maine has the highest percentage of so-called dual-eligibles in the nation so this provision is especially important here. The bill also requires improved customer service, for both seniors and pharmacists.

Rep. Allen has signed onto another bill that would offer a traditional Medicare-style drug benefit rather than adding the bureaucracy of private insurers between the federal dollars and the pharmacies. It would also allow the federal government to negotiate Medicare drug prices, which is currently prohibited. Congress, fair to say, is not yet ready to reconsider its expensive decision on the original Medicare bill – perhaps if the price of the program rises beyond the $600 billion or $700 billion where it now stands, the idea would look better.

For now, however, fixing what amounts to rollout errors and making sure states are repaid for providing Medicare loans would be plenty.