Diagnosis Time on the Hill

By Shailagh Murray and Charles Babington
The Washinton Post Tuesday, January 31, 2006

Is the Medicare drug benefit suffering from start-up pains, or is there something more serious going on?

Lawmakers got an earful from seniors about the new program while they were home for the winter recess. Now that Congress is back in session, lawmakers will begin weighing whether to make legislative adjustments or wait and see whether the glitches work themselves out.

On Thursday, Medicare officials will testify before the Senate committee on aging about how the various problems are being addressed. Big concerns include a coverage breakdown affecting low-income seniors who are eligible for both Medicare and Medicaid, forcing many states to intervene to pay for their prescriptions, and the dizzying array of insurance plans that many beneficiaries must sift through to find the one that best suits their needs.

Next Wednesday, the Senate Finance Committee will take up the matter, a follow-up to a meeting held last week between panel members and Medicare officials, including Health and Human Services Secretary Mike Leavitt. After that session, Finance Chairman Charles E. Grassley (R-Iowa) said he wanted to preserve the current approach to covering "dual-eligible" beneficiaries. He said he agreed with Leavitt's assessment that no legislation was needed at this time.

"We should focus on administrative remedies because they will be faster than legislation," Grassley said, while acknowledging that "yes, there have been problems, and, yes, they need to be fixed and fixed fast."

As Democrats see it, the greater the sense of crisis, the more likely the backlash by elderly voters in the November midterm election. Although the benefit took effect just a month ago, on Jan. 1, Democrats are pressing Republicans to streamline the benefit, to make it easier for seniors to navigate, and to provide emergency relief for people who are having trouble getting their prescriptions filled.

Rep. Henry A. Waxman (Calif.), a senior House Democrat, vented about the plan in the party's Saturday radio address. "Instead of using Medicare, which seniors and persons with disabilities have relied on for years," he said, "the program was turned over to hundreds of private insurers who can charge what they want, cover what drugs they want and change what they cover at will."

© 2006 The Washington Post Company