Possible changes to Medicare drug program after today's enrollment deadline passes

WASHINGTON -- A pivotal Republican is joining the congressional drive to eliminate the financial penalty for people who miss today's deadline for enrolling in the Medicare drug benefit, the latest sign of a growing rebellion against President Bush on the issue.

Rep. Nancy Johnson said she has talked to enough colleagues to believe such a proposal would pass, probably in the fall, and plans to introduce legislation to waive the penalty.

"The bottom line is this is a democracy, and the Congress responds to the people and shapes the program so it's good for them," said Johnson, who heads the House Ways and Means' subcommittee on health.

"I think it's fair and reasonable to eliminate the penalty" for 2006, the Connecticut Republican said.

It is also significant that the Republican chairman of the Senate Finance Committee is not ruling out an effort to block the penalty. Sen. Charles Grassley of Iowa said he will not consider changes to the prescription drug program, in place since Jan. 1, until he goes over final enrollment figures.

"If I told you on April 15 you didn't have to file your income taxes until April 30, you wouldn't do it," he said.

With the endorsement by one of the program's leading supporters, Johnson joins the handful of GOP lawmakers in the House and Senate who have split publicly with the Bush's administration's position that the enrollment deadline and late penalty should remain.

Exceptions made

The administration has made an exception for people who qualify for extra help because of their low income.

Under current law, people who wait until December to enroll would have $2.31 per month added to their monthly premium. That amount would rise annually to reflect the national average premium for that particular year.

Johnson said the drive to waive the penalty does not reflect concerns about a program criticized by Democrats as more beneficial to drug companies and insurers than to older people and the disabled.

"What is true, is absolutely true, is that seniors are saving a lot of money," she said. "It's lifting burdens off the back of retirees to a degree never imagined."

Democrats pledge to keep pressing to extend the deadline and waive the penalty for people who sign up after today.

Rep. Charles Rangel of New York, says he hears nothing but complaints about the program from his constituents.

"I really think it's a cruel thing to penalize people for what has been admittedly a very complex procedure in order to get the drugs," he said. "To put a penalty for the rest of their lives on our oldest citizens, I think, is just an improper and wrong thing to do."

Around the country, thousands of volunteers are helping to enroll Medicare beneficiaries into the program. The administration's latest estimate indicates that about 6 million beneficiaries remain without prescription drug coverage. Democrats contend the number is probably closer to 9 million.

Susie Heilman of Denver has spent the past six months signing people up. She said she agreed the deadline should stay, but there should be some relief for those who sign up later.

Heilman, a counselor at the Senior Health Insurance Assistance Program, gets as many as two dozen calls an hour from older people asking for her help in selecting a private drug plan.

"I've been doing this for 20 years. I've never heard the Medicare population so confused as they are now," she said. "This is the most God-awful confusing benefit that has ever been foisted on the Medicare beneficiary."

Heilman hears primarily from low-income people who have yet to enroll. Yet public opinion polls show that most people who do get government-subsidized insurance for their medicine are satisfied with their coverage.

The government estimates that the average participant will save about $1,100, though it is possible some people may not save at all based on their drug needs and the plan they select.

About three-quarters of older people enrolled in a drug plan through Medicare say they are satisfied with that coverage, according to the Kaiser Family Foundation, a health research organization.

The administration says there are about 43 million beneficiaries. About 37 million now have prescription drug coverage; most of them had coverage before Jan. 1. The administration's latest estimate reflects that about 10 million people now have drug coverage who did not have it last year.

Grassley said enrollment has exceeded his expectations, and there has been a noticeable turn in the attitude of Iowans he meets. In February, he heard mostly complaints. Now it is mainly compliments.

Health and Human Services Secretary Mike Leavitt acknowledges the first two weeks or three weeks after the Jan. 1 start of the program were bumpy. Many poor beneficiaries had trouble shifting from Medicaid to Medicare. Most states had to step in to help people pay for their medicine.

"The measure of success isn't what it was like the first two weeks. The measure of success is what's it like today and what it will be like a year from now," Leavitt said during a stop in Philadelphia on Friday. "By every measure, this has been a successful implementation."

Forty-six senators wrote Leavitt last week asking him to extend the deadline through the end of the year and to waive the penalty. Three of the lawmakers were Republicans -- Sens. Arlen Specter of Pennsylvania, Mike DeWine of Ohio and Susan Collins of Maine.

Leavitt did act to help poor beneficiaries who qualify for extra financial aid with their medicine. But he said Friday he does not have the power to do that for all those on Medicare.