Signups Not at Fever Pitch for Medicare Drug Cards

Amid signs that the Medicare drug discount card is off to a rocky start, congressional Democrats and Republicans said Wednesday that they would find other ways to make prescription drugs more affordable for the nation’s 41 million seniors and disabled persons.

As of Tuesday, the first day beneficiaries could use a card, 2.8 million were enrolled in the program, but all but about 400,000 of those had been automatically signed up by their Medicare HMOs. Health and Human Services Secretary Tommy G. Thompson declared the administration “very pleased” with the numbers, saying that “May was the month for window-shopping” and that enrollment was sure to take off in the coming weeks.

But Democratic lawmakers said the figures proved that the program was “an absolute disaster” and “a huge embarrassment to the administration.”

Seniors “have shown great, good common sense by rejecting this card by the millions,” said Sen. Hillary Rodham Clinton (D-N.Y.).

Democrats said they would continue to push for the automatic enrollment of low-income seniors in the discount card program, which the Bush administration has resisted, as well as the legalization of drug imports from Canada and direct government negotiation with drug companies for lower prices, two populist proposals prohibited by the Medicare law.

A leading Senate Republican, meanwhile, indicating that his party is feeling the drug-price heat this election year, introduced legislation designed to respond to growing public demand for importing less-expensive U.S.-made drugs from Canada and some other countries.

“The genie is out of the bottle,” said Sen. Judd Gregg (R-N.H.), chairman of the Senate Health, Education, Labor and Pension Committee.

The bipartisan push to give seniors access to lower drug prices is reminiscent of the political debate four years ago, when Democratic presidential candidate Al Gore and GOP nominee George W. Bush tried to outdo each other in pledging to produce a Medicare prescription drug benefit for seniors. But since a sharply divided Congress passed a Medicare reform bill last fall, Bush and Republican lawmakers have not reaped the political windfall they had hoped for.

The administration has spent more than $22 million promoting the new Medicare law. Yet public opinion polls, interviews and anecdotal evidence indicate that many seniors remain uninformed or undecided about the discount card, a temporary measure designed to offer Medicare beneficiaries some help with drug prices until the full benefit takes effect in 2006.

Some seniors say they are deeply disappointed in the program.

“It’s like a hoax that’s been foisted on the public,” said Ethel Calandros, 69, of East Norwich, N.Y. Calandros, who suffers from glaucoma, uses two kinds of eyedrops and takes medications for seasonal allergies. She said that when the program was first announced, she thought she would get a card.

But after talking to her pharmacist, failing to get through on Medicare’s toll-free information line ([800]-MEDICARE) and being confused by the choices among 40 national cards and 33 regional ones, she has all but given up.

“There’s nothing here,” she said in a telephone interview, describing the plan as “like the emperor’s new clothes.”

“Come on, give us a break here,” she said. “I would like one card.”

Thompson said Tuesday that he was “somewhat concerned” about indications that very few low-income seniors and disabled persons had signed up for a Medicare discount card.

For individuals who earn less than $12,569 a year and couples with an income under $16,862, the card comes with a total value of $1,200 in free prescription drugs. In addition, several drug manufacturers have said they would provide free drugs for low-income seniors whose medication needs exceed the annual subsidy.

“There’s just no sense for them to leave the money on the table,” Thompson said.

Seven states with their own pharmacy assistance programs for low-income seniors are automatically enrolling participants in the Medicare discount card program. House and Senate Democrats have introduced legislation that would require Medicare to “auto-enroll” all low-income seniors. The administration is reluctant to do that, although Thompson on Tuesday called it “a possibility.”

“A number of issues would have to be sorted out,” added Medicare administrator Mark B. McClellan. “It is not on the table at this time.”

Thompson predicted that more seniors would sign up for a drug discount card as competition among card sponsors drives down drug prices. But Rep. Henry A. Waxman (D-Los Angeles) released a study Wednesday showing that between May 3 and Tuesday, the lowest discount card prices for two of the drugs most often prescribed for seniors -- the acid reflux medications Nexium and Protonix -- had increased by 13% and 19%, respectively.

In the past, the Bush administration has strongly opposed the importation of U.S.-made drugs from Canada and other countries, saying their safety could not be verified. And Republicans were careful to note Wednesday that Gregg’s bill did not represent a shift in the administration’s position.

“The White House was not involved” in the writing of the bill, said a Senate Republican aide who spoke on condition of anonymity.

Gregg said his bill was better than one passed last year by the House and another introduced by Sen. Byron L. Dorgan (D-N.D.) and 21 co-sponsors, including Republican Sens. Olympia J. Snowe (R-Maine) and John McCain (R-Ariz.). By allowing imports only from wholesalers, pharmacies and Internet companies licensed by the Food and Drug Administration, his bill would go further to ensure that imported drugs were safe and genuine, Gregg said.