FEBRUARY 15, 2006 -- Democrats on Wednesday intensified their criticism of the way the Medicare drug benefit started, announcing plans to highlight the problems and potential solutions in "hundreds" of meetings with senior citizens and the disabled.
Democrats also outlined legislative changes they said should be made in the benefit, telling reporters in a Capitol Hill press conference that their proposals would assure that the most vulnerable Medicare beneficiaries will have uninterrupted access to medicines.
Sen. Richard J. Durbin, D-Ill., said seniors in his state "wanted a Medicare benefit that would lower their prices. What they have today is a confusing benefit, a law that prohibits Medicare from negotiating with pharmaceutical companies, and a plan that guarantees drug companies billions of dollars in profits."
Durbin, along with Michigan Democrats Sen. Debbie Stabenow and Rep. John D. Dingell, hammered away at themes likely to be repeated over and over during this fall's election campaigns. They said the benefit provides drug and insurance companies with billions of dollars in profits while bogging seniors down in needless complexity and confusion.
But at a House Energy and Commerce Committee hearing, Republicans countered that Democrats are exaggerating the problems for political gain.
"Some sense political advantage in condemning the program and can't bring themselves to admit that free markets actually work," said Committee Chairman Joe L. Barton, R-Texas, referring to lower-than-projected premiums charged by Medicare drug plans.
Provisions outlined by Democrats would require all drug plans to provide a 60-day prescription when a drug is not covered by a plan or when a pharmacist is unable to confirm plan enrollment. A standardized appeals process would be required with medications provided during the appeal.
Plans could not drop covered drugs during the year, raise the cost to the beneficiary, or otherwise set up new barriers to access to medications under the Democratic proposal. A beneficiary whose drug is not covered by a plan would be permitted to switch plans.
In addition, Medicare would be required to reimburse family members, charities, or states that picked up prescription drug costs for a beneficiary denied coverage because of administrative failures at CMS. Pharmacies could bill Medicare directly for prescription costs during a transition period if a beneficiary's private plan coverage could not be confirmed because of administrative glitches.
But Health and Human Services Secretary Michael O. Leavitt told the committee that problems marring the start of the drug benefit can be fixed through administrative action. Barton said while there are glitches, "critics have tried to make patients believe that they are not smart enough to understand the new Medicare drug benefit, that it provides inadequate coverage, and that signing up isn't worth their time because it cannot save them any money. The critics are simply wrong."
Barton emphasized that he will work to get rid of the glitches. "We will have the first of what will likely be several hearings on this topic on March 1," he told Leavitt.