WASHINGTON — Despite a stony silence from the White House, Congress is warming up to the idea of waiving the penalty for seniors who missed Monday's sign-up deadline for the Medicare drug benefit -- and doing so in time for the fall elections.
Forgiving the penalty for this year is seen as a compromise between Republicans who firmly resisted pressure to extend the sign-up period and Democrats who argued that beneficiaries needed more time to figure out the biggest and most complicated change to the program in 40 years.
Even so, waiving the penalties for this year is unlikely to quell all critics of the drug benefit. Many Democrats also want to give seniors a one-time chance this year to switch among the private prescription plans providing the coverage. And some want the government to negotiate drug prices directly with manufacturers. That would save money, they say, and the savings could be used to narrow the "doughnut hole."
The doughnut hole is a coverage gap built into the program to save the government money. When seniors' total drug costs reach $2,250 for the year, they must pay the next $2,850 in costs themselves, after which Medicare pays 95% of all further drug expenses.
"The penalty issue and the doughnut hole are going to be hitting around the time of the election," said Drew Altman, president of the Kaiser Family Foundation. "It will be a lot easier to solve the enrollment penalty than to plug the doughnut hole."
Also on Monday, the California Legislature passed a bill extending the state's emergency prescription coverage program through January 2007. The help is currently available to low-income and disabled residents who receive medical benefits from both state and federal programs. California set up its fail-safe system after thousands of beneficiaries reported trouble getting prescriptions filled under the Medicare benefit.
In Washington, the congressional proposal to waive the late enrollment penalty came from a senior House Republican, Rep. Nancy L. Johnson of Connecticut, chair of the Ways and Means health subcommittee and one of the authors of the drug benefit. It's needed, she said, because Democratic critics have frightened some seniors into staying on the sidelines.
"As we come up to the [enrollment] deadline, I wanted to do something to cut the worry," said Johnson. "Some of my colleagues have really behaved shamefully with regard to this program. I have never seen such a concerted effort by those in the other party to scare people from even looking into extraordinary benefits that are being provided."
