Washington, D.C. – When the Medicare (Part D) drug legislation was enacted, President Bush and congressional leaders boasted that it would be a great help for low-income seniors. A report released today shows that this promise is unfulfilled and more than three out of four low-income seniors have not enrolled in the program.
The report, released today by the consumer health organization Families USA, shows that enrollment in the low-income drug subsidy program is very low:
* Only 1.7 million low-income seniors out of 7.2 million eligible for special subsidies have enrolled in the program—a mere 24 percent;
* In 16 states and the District of Columbia, at least four out of five seniors eligible for low-income subsidies are not receiving them [see Table 1]; and
* In only six states (Arkansas, Delaware, Kentucky, North Carolina, Texas, and Vermont) has enrollment exceeded one-third of those eligible for low-income subsidies.
“Contrary to promises by the President and congressional leaders, low-income seniors are not receiving help to make their medicines affordable,” said Ron Pollack, Executive Director of Families USA. “These are the very people who need help the most, yet the Administration’s promises to them are much more rhetorical than real.”
The extra help promised to low-income seniors includes special subsidies to cover their Part D premiums, out-of-pocket costs (such as deductibles and copayments), and the elimination of coverage gaps such as the so-called “doughnut hole.” The maximum annual income that a senior can have to be eligible for such subsidies is $14,700.
In addition to the seniors eligible for these low-income subsidies and not receiving them, there is another group of even poorer seniors who are actually worse off today than they were prior to January 2006, according to the Families USA report. This group of 6.3 million people is so poor that they qualify for both Medicare and Medicaid.
Prior to January 2006, these so-called “dual eligibles” received drug coverage through Medicaid. Once Part D began, dual eligibles lost their Medicaid drug coverage and were automatically enrolled in a private Medicare drug plan. Three factors made them worse off than they were before Part D began:
* First, the 6.3 million dual eligibles faced new, more restrictive formularies and utilization management rules that limited their access to prescribed medicines;
* Second, about half of all dual eligibles are charged higher copayments than they paid when they had Medicaid drug coverage; and
* Third, many encountered confusion at pharmacies during the earliest stages of the new program, and some did not receive their medicines.
The Families USA report also indicates that the Administration’s claim that it has enrolled approximately 30 million people into Medicare Part D is misleading. According to the report, at best, only 8.6 million of the 30 million were without drug coverage before Part D began in January 2006. [See Table 3.] Over two-thirds (71 percent) of the people counted by the Administration had drug coverage before January 2006.
“There are millions of seniors who need drug coverage and are not receiving it,” Pollack said. “The Administration and Congress should extend the May 15 deadline for program enrollment and should waive penalties associated with enrollment that occur after May 15.”
A copy of the report can be found on the Families USA Web site at www.familiesusa.org
