Medicare officials tout figures; critics say plan is confusing, number enrolled is low
By Julie Appleby - USA TODAY

At least 1 million people have joined new stand-alone prescription drug plans offered by insurers, Medicare officials said, a month into what some have criticized as a confusing enrollment process.

Supporters of the new program said the enrollment figures show strong progress in the biggest expansion of Medicare since its inception in 1965, while critics called the number "abysmally low."

"One million people took the time to learn their options and actually make a decision," Mike Leavitt, secretary of Health and Human Services said. "And more are coming every day."

Overall, Medicare officials said, more than 22 million seniors and disabled Americans will have some kind of drug coverage starting Jan. 1. Leavitt said the program is well on its way to having the projected 28 million to 30 million members by the end of 2006.

But critics said the figures are misleading:
About half -- 10.6 million -- are retirees, from government, military and private-sector employers, most of whom already had drug coverage.
Another 6.2 million are low-income seniors and disabled people who were automatically switched into Medicare from state drug programs.
4.4 million are in Medicare Advantage managed care plans, most of which already had drug coverage.

"It seems virtually all the 21 million have drug coverage now," says Tricia Neuman of the Kaiser Family Foundation, a non-partisan research group. "It's unclear if the enrollment number represents a major improvement in coverage."
Robert Hayes of the Medicare Rights Center in New York, an advocacy group, called the enrollment numbers "abysmally low."

Rep. Henry Waxman, D-Calif., said the 1 million enrollment figure represented about 10 percent of the 10 million that Medicare projected would sign up independently by the end of 2006 and could mean "the complicated and confusing nature of the benefit may be resulting in lower-than-anticipated enrollment."
Waxman and others have said that people have been confused by the large number of choices and complicated rules.

But Medicare chief Mark McClellan defended the program, saying 1 million new members in 28 days is a good start. Also, fewer employers dropped retiree coverage than critics had feared, he said.

About a half-million more people are expected to enroll in January, he said, and enrollment will continue until May 15.

Jeanne Ripley, a vice president at Halleland Health Consulting, a health care consulting practice, says the enrollment looks good.

"If some critics are saying a million isn't very many, I would say it's a million who probably didn't have coverage before," Ripley says. "How can anyone say that's not a good thing?"

Medicare has 43.1 million beneficiaries. Of those, estimates vary on the number who don't have some kind of drug coverage. The Kaiser foundation says nearly 14 million don't have coverage, while Avalere Health, a for-profit research group, says about 17 million do not.

"One million out of 17 million is about 6 percent of the way there," says Daniel Mendelson, president of Avalere. "They have a way to go."
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ABOUT THE AUTHOR

Russell Wilcox is a retired college professor who spends several months in Florida and several months in Rhode Island each year, and whose interests include boating and sailing, political activism, ballroom dancing and bridge. He has an MBA from Harvard, a Computer Systems CAGS from Bryant and a BS from Northeastern. He has worked in industry for EG&G and Texas Instruments, operated his own business with more than 200 employees, and served as Director of the Computer Information Systems Program for Stonehill College. He is a published author of two technical studies, and is the proud father of four children and the proud grandfather of six grandchildren. A holder of two patents in microchip connections and a true product of the melting pot, his father is the son of a Yankee farmer, and his mother the second generation daughter of Italian immigrants who retained their culture, but strove mightily to become Americans, sending four sons to fight against Hitler and Mussolini.