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Medicare Drug Program News
Medicare's Claim of No Price Hike in Drug Plans'
Average Premium Challenged by Congressman
Rep. Waxman says
average up 13.2%, some find increases as high as 44%
 October
13, 2006 – The average premium for Medicare drug plans will be the same
in 2007 as in 2006 - $24, according to the Centers for Medicare &
Medicaid Services. Rep. Henry Waxman (D-Calif.) had his staff check the
numbers and they say the average premium is more likely to be $29 – a
13.2% jump.
"It's all about methodology," says Associated Press
writer Kevin Freking. "The administration includes drug plans as well as
managed care plans that offer drug coverage in its calculations. The
managed care plans, called Medicare Advantage, offer comprehensive
medical coverage and are heavily subsidized by the federal government."
But Waxman only included plans
offering just drug coverage, which is what about 90% of seniors choose.
Analysis by several newspapers indicates Waxman's
estimate may be closer to reality. Some plans are actually increasing
their premiums by as much as 44% for the same plan they offered in 2006.
KaiserNet.org looks at this controversy in its
daily report and also examines some of the politics that is involving
the Medicare drug program.
 Analysis
of Stand-Alone Medicare Drug Plans Shows Average Premium Increase of
13.2%, Higher Than Projected by CMS, Rep. Waxman Says
CMS
estimates that Medicare prescription drug plans in 2007 will have
average monthly premiums of $24 -- the same as this year -- "appear to
be wrong," Rep. Henry Waxman (D-Calif.), ranking member of the
House Government Reform Committee,
said on Tuesday in a letter to
HHS
Secretary Mike Leavitt, the
Washington Post
reports (Lee, Washington Post, 10/13).
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Senior Citizens Pay More for Drugs Because Congress
Refuses to Allow Medicare to Negotiate Like VA
Consumer Union finds seniors in donut hole can
do better shopping around for best price
October 12, 2006 – Consumers Union released a
report this week highlighting a study that found senior citizens who
have fallen into the Medicare Part D "donut hole" can get better prices
shopping around than through their Medicare drug plan. The headline was
"Floridians in Medicare Donut Hole Can Get Better Drug Prices." What the
headline should have been, however, is "All Senior Citizens Paying Big
Drug Price Because Medicare Does Not Negotiate Prices Like Veterans
Administration."
Read
more...
Medicare Releases 2007 Drug Plans Available in Each
State
 Links below will take
readers to their state plans available for enrollment Nov. 15
September 29, 2006 – The Medicare drug programs
available for 2007 in each state were released today by the Centers for
Medicare and Medicaid Services. Check
the link in the sidebar on this
page to find the information for your state. Open enrollment begins
November 15. Those satisfied with their current plans do not have to
take any action but CMS says in 2007 there are new options with lowers
costs and more comprehensive coverage.
Read
more...
Senior Citizens to See Medicare Drug Plans Cost
About Same in 2007
CMS credits smart plan choices and competitive
bidding by plans
August 16, 2006 – Senior citizens can expect their
Medicare drug plan to cost about the same in 2007 as it did this year -
about $24 per month, or less, on average, according to an announcement
yesterday from the Centers for Medicare and Medicaid Services. CMS says
the "lower than expected" cost for both years is due to strong
competitive bidding by the health plans and smart plan choices by
beneficiaries.
Read
more...
Read more
on
Medicare
or
Medicare Drug Program |
|
CMS on Sept. 29 in a statement said that Medicare
beneficiaries will have average monthly premiums of $24 in 2007 "if they
stay in their current plan, about the same as in 2006" (Appleby,
USA Today,
10/13). However, Waxman said an analysis conducted by his staff found
that average monthly premiums in 2007 will increase about 13.2%, to $29
(Carey,
CQ HealthBeat,
10/12).
According to the Post, the "discrepancy arises from
the different ways that the two sides calculated average premiums." The
CMS estimate includes monthly premiums for both stand-alone Medicare
prescription drug plans and Medicare Advantage plans, which offer a
range of services and do not have separate premiums for prescription
drug coverage (Washington Post, 10/13).
About seven million Medicare beneficiaries are
enrolled in Medicare Advantage plans (USA Today, 10/13). The Waxman
analysis includes only stand-alone Medicare prescription drug plans,
which account for about 16 million enrollees in the prescription drug
benefit.
Waxman Analysis
The letter from Waxman states that the CMS estimates "disguise
significant increases in premiums for Medicare drug plans" (Washington
Post, 10/13).
According to the Waxman analysis, average monthly
premiums for Medicare prescription drug plans that have the same
deductible and same coverage levels from 2006 in 2007 will increase by
11.1%.
Average monthly premiums for the lowest-priced
Medicare prescription drug plans will increase by more than 44%, to
$13.58 from $9.46, according to the analysis (Carey, CQ HealthBeat,
10/12).
The analysis finds that premiums will increase for
77% of enrollees who chose the same plan as this year (USA Today,
10/13).
"The release of erroneous information about the
cost of premiums -- whether deliberate or not -- is a disservice to
millions of seniors and a discredit to the department," the letter
states (Washington Post, 10/13).
The letter adds, "Combining the actual premiums for
drug plans with these estimates in managed care plans is mixing 'apples'
and 'oranges' with the average price of 'fruit.' It is not merely
confusing arithmetic, it is deceptive advertising" (Carey, CQ HealthBeat,
10/12).
Waxman in a statement said, "The only way the
Administration's numbers can possibly add up is by including artificial
estimates of the costs of drug coverage in Medicare managed care plans.
Most seniors won't abandon traditional Medicare just to keep the costs
of their drug coverage from going up, nor should they have to."
Comments
CMS Administrator Mark McClellan in a statement said, "The
congressman's analysis is inaccurate and misleading because it is
selective, measuring just one of the plan option beneficiaries can use
to get their prescription drugs" (Washington Post, 10/13).
McClellan added that 83% of Medicare beneficiaries
currently enrolled in the prescription drug benefit will have access to
at least one prescription drug plan with lower premiums in 2007 (Carey,
CQ HealthBeat, 10/12).
Tricia Neuman, a
Kaiser Family
Foundation vice president and director of the
Medicare Policy
Project at the foundation, said, "The dollar amounts may not
be so great, but premiums are nonetheless on the rise."
Neuman added, "I think seniors will be well advised
to go back to the drawing board and revisit the decision they made for
2006."
Dan Mendelson, president of
Avalere Health,
said, "These are commercial plans that change from year to year based on
their experience, and the only way for seniors to navigate the
marketplace effectively is to constantly reassess their options"
(Alonso-Zaldivar,
Los Angeles Times,
10/13).
>>
AP story – click here
Election Issue?
The
Boston Globe
on Friday examined how the Medicare prescription drug benefit has become
an issue in some congressional races. For example, the "closely watched"
race between incumbent Rep. Clay Shaw (R-Fla.) and state Sen. Ron Klein
(D) in the Florida 22nd district is "attracting an added layer of
attention" because of a focus on the so-called "doughnut hole" coverage
gap in the Medicare prescription drug benefit, the Globe reports.
According to the Globe, "Democrats remain confident
that doughnut hole angst can mobilize voters." However, Republicans
believe that "most seniors are happy with the benefit because they are
spending less on prescription drugs," the Globe reports. Drew Altman,
president of the Kaiser Family Foundation, said, "There is, in general,
a big disconnect on health." He added, "People care about (health care)
deeply. It's actually their No. 1 personal and family economic worry.
But it's not their No. 1 voting issue" (Henderson, Boston Globe, 10/13).
Opinion Piece
"Democrats are still on the warpath against" the Medicare
prescription drug benefit, despite "abundant evidence of its success,"
Roll Call Executive Editor Morton Kondracke writes in an opinion piece,
adding that Democrats "threaten to undermine future success if they take
control of Congress."
He writes, "If Democrats do take over either the
House or Senate, or both, they should strive to improve on the Medicare
reform record set by McClellan and the Bush administration -- not
undermine it with top-heavy government regulation."
According to Kondracke, "Congress should see to it
that the reform agenda advances and that doctors, health plans, drug
companies and hospitals have incentives to compete on the basis of their
ability to keep people healthy -- not just treat sick people at
government-set prices."
He concludes, "If they do take control, Democrats
need to reform not only health care, but their own thinking" (Kondracke,
Roll Call, 10/13).
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