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Rules for Drug Cards Draw Senators’ Ire

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Times Staff Writer

The political battle over the Medicare prescription drug law heated up again Friday, with a dozen Democratic senators calling on the Bush administration to change the rules for the discount-card program, while a top House Republican accused the Democrats of trying to discourage poor seniors from saving money.

The Democrats’ demand came in a letter to Health and Human Services Secretary Tommy G. Thompson a day after the administration began offering information on how much specific drugs would cost under various Medicare-endorsed discount cards.

The senators cited what they called a “confusing process” for enrollment and early analyses showing that discount-card prices may be higher than those available over the Internet or in Canada. As a result, they said seniors should be given a 30-day grace period during which they could change from one card to another.

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But Rep. Bill Thomas (R-Bakersfield) rejected Democrats’ criticism of the discount cards, saying that prices soon would begin to come down. He said Democratic critics of the Medicare reform law apparently “would be happy if fewer low-income seniors take advantage of the money on the table.”

Thomas is chairman of the Ways and Means Committee and led the House-Senate conference that produced the final Medicare bill.

Thomas also suggested that Americans should not expect to find the solution to high drug prices in the legalization of imports from Canada. Referring to a meeting House leaders had Thursday with Canadian Prime Minister Paul Martin, Thomas said Canadians were beginning to understand that a change in U.S. law could lower supplies and raise drug prices in their country.

Although making it legal for consumers to import prescription drugs is supported by a growing number of Democratic and Republican lawmakers, Thomas said, the Canadian solution “isn’t what it appears to be.” And as a federal task force and others explore whether it is possible to certify the safety of such imports, Thomas said, “More people are beginning to sober up.”

The latest escalation in the partisan war over the new Medicare law comes at a critical time for the administration. President Bush and Republican lawmakers had hoped that the law, which added a prescription drug benefit to Medicare coverage, would win them increased support from seniors in this fall’s elections.

But Democrats, including presumptive presidential nominee Sen. John F. Kerry (D-Mass.), had characterized the law as a giveaway to drug manufacturers and insurance companies.

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Despite the administration’s ongoing $30-million advertising campaign, public opinion surveys indicate that most seniors remain uninformed about the law and that the more they learn about it, the less likely they are to support it.

Republicans have been counting on the start-up of the discount drug card, a temporary program designed to help beneficiaries with medication costs until the full benefit takes effect in 2006, to increase public support.

Administration officials say Medicare-endorsed discount cards sponsored by private companies would offer most seniors price discounts of 10% to 25%. In addition, about 7 million low-income and disabled seniors would qualify for a $600 annual subsidy.

On Thursday, the government began giving seniors information through two sources -- medicare.gov and 1-800-MEDICARE -- about their card options and about prices for specific prescription drugs. Seniors can sign up for one card for an annual enrollment fee of up to $30, beginning Monday. The discounts kick in June 1.

But the website appeared to get off to a shaky start. It provided no information about many of the drug cards, and some card sponsors said Friday that drug prices listed for their cards were inaccurate.

At the same time, analyses by congressional Democrats and consumer-advocacy groups raised questions about the value of the Medicare cards’ discounts.

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A study released Friday by the Medicare Rights Center in New York compared prices for the 10 top-selling drugs for the elderly in Manhattan. Though the prices offered by three Medicare-endorsed drug discount cards were lower than the retail prices charged by a local drugstore, they were higher than prices offered by drugstore.com in Washington state and Canada’s canadadrugs.com.

Thomas and other Republicans rejected such comparisons, saying that the process had just begun and that the public nature of the website would encourage card sponsors to lower their prices during the month-long enrollment period. Earlier this week, Thompson encouraged seniors to delay signing up for a card until more information was available and prices had stabilized.

That prompted Sen. Minority Leader Tom Daschle (D-S.D.) and 11 other Democratic senators to urge Thompson on Friday to give seniors 30 days to switch cards. Under current rules, drug-card sponsors can change their prices weekly but seniors signing up for a card this year cannot switch to a different card until next year.

HHS spokesman Bill Pierce said there was no reason to give seniors a grace period because “that’s what they have right now.”

“The month of May is an opportunity for seniors to shop. Visit the website as many times as you need. Call the 800 number.... They’ve got the whole month of May to shop for benefits that start June 1, but they can sign up whenever they want.”

Thomas, speaking to a group of reporters over breakfast, strongly criticized Democrats for undermining a law that he said would not only help seniors with drug costs but also would begin to shift the nation’s healthcare system away from government price-setting and employer-based insurance coverage.

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Thomas had particularly harsh words for Sen. Edward M. Kennedy (D-Mass.), the law’s leading congressional critic. “Would Kennedy really be gleeful if it turns out that fewer low-income seniors take advantage of the $600” subsidy, he asked.

A Kennedy spokesman rejected that notion, saying the senator opposed the law because “it undermines Medicare and forces seniors into HMOs and does nothing to control the high price of drugs.”

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