Editorial: Another black eye for Medicare Part D

01/14/2006

This time, the victims are highly vulnerable.

Star Tribune
Last update: January 13, 2006 – 7:09 PM

On Jan. 1, hundreds of low-income elderly and disabled Minnesotans woke up to a nasty surprise. A vaunted new federal program designed to help them pay for prescription drugs somehow forgot that they existed, and meanwhile the government had canceled their previous medication subsidies. Patients with dementia, epilepsy, cancer and other life-threatening ailments suddenly found themselves turned away at the pharmacy counter, facing huge prescription bills or relying on the goodwill of local druggists and insurance companies.

The same problem has cropped up in state after state during the last two weeks in an absolutely appalling breakdown of the federal Medicare program. So far at least four governors have simply taken matters into their own hands, offering financial assistance to these constituents, and we hope that Gov. Tim Pawlenty, who was looking into the matter this week, can find a way to address the problem in Minnesota until Washington comes up with a solution. And by the way, Minnesota taxpayers shouldn’t have to foot the bill.

The fiasco of so-called “dual eligibles” is yet another embarrassment for Medicare Part D, the massive new program to help elderly Americans pay for prescription drugs. Congress created it in 2003, in a much-ballyhooed effort to modernize Medicare. But at the last minute, lawmakers decided that 6.4 million low-income patients who used to get drug subsidies through Medicaid, a program for the poor, would have to switch over to Medicare, a program primarily for the elderly.

What’s galling is that federal authorities were warned about this very problem. Advocacy groups told lawmakers that dual eligibles—many of whom live in nursing homes, some with mental impairments—are not appropriate customers for the mind-boggling new marketplace of Part D insurance plans. As recently as December, governors warned Medicare that thousands of beneficiaries were falling through the cracks.

Those governors got a string of promises—and now a string of failures. In Maine, some 50 percent of eligible patients simply didn’t turn up in the federal database that was supposed to help pharmacists verify insurance coverage. In Minnesota, hundreds of patients are finding that Medicare hasn’t granted them the automatic low-income subsidy that Congress promised.

Now governors are left either picking up the pieces or telling constituents they’re powerless to do so. It’s not a pretty choice.