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Organization Alarmed By Low Enrollment of Low-Income
in Medicare Drug Program
Only 660,000 of 5.7 million approved for assistance
at end of November
Dec. 5, 2005 - With one month left before the new
Medicare prescription drug program begins on January 1, fewer than one
out of nine low-income seniors have been approved to receive low-income
drug subsidies. Without such subsidies, participation in the new drug
program will be unaffordable for those low-income seniors, declares a
news release by Families USA, which says it is a non-partisan
organization dedicated to the achievement of high-quality, affordable
health care for all Americans.
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Families USA says, "According to the Social
Security Administration, only 660,000—out of approximately 5.7 million
low-income seniors eligible for subsidized drug coverage that must apply
and be approved for such coverage—were approved for low-income subsidies
as of November 29."
The news release says these are not the 6 million
"dual eligibles," which are covered by both Medicare and Medicaid and
will be automatically enrolled in the Medicare Part D drug program.
These
are the 5.7 million that the Congressional Budget Office had estimated
would be eligible for some assistance with paying for the new program
that begins January 1.
“The most important part of the new Medicare drug
legislation was the special help that was supposed to be made available
for low-income seniors,” said Ron Pollack, Executive Director of
Families USA in the news release. “Unfortunately, these numbers are very
discouraging, and it now appears likely that many millions of low-income
seniors will be without the help they need to make drugs affordable.”
During the past few months, there have been many
examples of the complexity of the new Medicare prescription drug
program. Less attention has been given to the complexity of the special
drug coverage and subsidies intended for low-income seniors, the
organization says.
According to the news release, three categories of
low-income seniors were established under the new Medicare legislation,
and each group will receive different benefits and will be enrolled
through separate processes. Below is the FamiliesUSA description of
these groups and processes.
"1. Non-Medicaid Low-Income Beneficiaries: At least
5.7 million low-income seniors and people with disabilities who receive
no Medicaid benefits are projected by the Congressional Budget Office to
be eligible for special drug subsidies under the new Medicare
legislation. They must proactively apply for this benefit, usually with
the Social Security Administration. To qualify, they need to have
incomes below 150 percent of the federal poverty level ($14,355 for a
senior living alone, $19,245 for a couple) and less than $10,000 in
assets for an individual and $20,000 for a couple. The actual amount of
the drug subsidies provided to these beneficiaries varies based on their
income and assets.
"According to the Social Security Administration,
3.8 million people have applied for low-income subsidies, but only
660,000 have been approved. The 660,000 approved applications constitute
only 10.5 percent of the low-income beneficiaries who must apply and be
approved for low-income subsidies.
"2. The So-Called “Dual Eligibles”: This is a group
of approximately 6.4 million low-income Medicare beneficiaries who
currently participate both in Medicare and Medicaid. Since this group is
readily identifiable, any dual eligible person who does not voluntarily
enroll in the program by January 1 will be automatically enrolled by the
government in a plan and will receive the low-income subsidy. Federal
litigation is pending to ensure that the automatic enrollment system
actually works.
"3. “Medicare Savings Program” Participants: These
approximately 1.1 million beneficiaries have slightly higher incomes
than dual eligibles and receive Medicaid subsidies to pay for their
Medicare premiums and cost-sharing. Since these low-income people are
also readily identifiable, those who do not voluntarily enroll in the
program will be automatically enrolled by May 15 in a plan and will
receive low-income subsidies.
The complexity of the Part D benefit is almost
certainly discouraging potentially eligible low-income beneficiaries
from applying, says Common Dreams.
“The general confusion and bewilderment experienced
by seniors is considerably worse for low-income seniors and has no doubt
contributed to low enrollment,” said Pollack. “Low-income seniors not
only have to navigate the maze of their Part D options, but they also
have the added burden of having to apply to a separate government
agency.”
A number of advocacy groups have expressed concern
that thousands of poor senior citizens will not be covered by the new
program when it begins in January. There has been particular concern
about those who now get their drugs through Medicaid, which will now
transition to Medicare drug coverage.
About Information Source:
Families USA says it "is a national nonprofit,
non-partisan organization dedicated to the achievement of high-quality,
affordable health care for all Americans. Working at the national,
state, and community levels, we have earned a national reputation as an
effective voice for health care consumers for over 20 years."
Website:
http://www.familiesusa.org.
Common Dreams News Service distributed the news
release and says it is a national non-profit
citizens' organization working to bring progressive Americans together
to promote progressive visions for America's future. Founded in 1997,
the Website say, "we are committed to being on the cutting-edge of using
the internet as a political organizing tool - and creating new models
for internet activism."
"We are funded exclusively by our members and
supporters - no corporate money, no advertising, no hidden agendas. With
a small staff and a network of volunteers, we are proud of what we've
accomplished on a shoestring budget."
Website:
http://www.commondreams.org/
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