WASHINGTON — A top Bush administration official acknowledged Thursday that the Medicare prescription program was too complicated for many of its intended beneficiaries to understand and said simplifying it was a top priority.
"Simplification is absolutely the next step in this process, now that we've got the benefit in place," Medicare Administrator Mark B. McClellan said during a Senate hearing on problems the program has had since its Jan. 1 introduction.
At the same time, McClellan opened the door to a possible extension of the May 15 deadline for signing up -- a step the administration has opposed but critics have said is needed to give seniors time to figure out the program's options. Under current rules, if Medicare recipients fail to enroll before May 15, they will have to pay higher monthly premiums permanently.
McClellan's comments may be the first sign that the administration recognizes that the complex program may have to be retooled to succeed.
Hundreds of thousands of seniors enrolled in the benefit program have run into delays or outright refusals in getting medications. Many pharmacists have yet to be paid by the private drug plans that contract with Medicare to deliver the government-subsidized benefit. At least 20 states stepped in with financial guarantees to make sure beneficiaries could get the medicines they needed; the administration agreed to reimburse the states.
The White House has promoted the drug benefit as a historic accomplishment and the most significant improvement to Medicare since its establishment in 1965. Spokesman Trent Duffy said Thursday that President Bush remained committed to the program, even though Bush didn't mention it in his State of the Union message this week.
Separately, the Medicare agency released estimates indicating that the drug benefit would cost less than expected: $678 billion over the next 10 years instead of the $737 billion projected last year. The average monthly premium for seniors this year is expected to be about $25, or 22% less than the $32 estimated in August.
McClellan said the main reason for the lower estimates was "robust competition" among the private insurers offering coverage. Other data released by the government suggested another factor might be at work: The previously rapid rate of increase in drug costs has slowed dramatically in the last two years because of a shift to generic medicines and other reasons.
