- The Washington Times - Tuesday, December 7, 2004


Jane Fumich and her team visit Cleveland’s churches, public-housing holiday parties and ward club meetings trying to give away the government’s money — without much success.

A year after the Medicare overhaul became law, the Bush administration is struggling to get the poor signed up for a drug discount card that comes with $1,200 in aid between now and 2006.

“Whether we get two or three or 20, we don’t worry about it. There’s no silver bullet,” said Miss Fumich, who directs the Greater Cleveland Access to Benefits Coalition and the city’s Department of Aging.

Today is the first anniversary of the Medicare prescription-drug law that President Bush and Republicans made their top legislative priority leading up to the 2004 election.

But the administration is finding it difficult to get the discount cards into the hands of those who could gain the most from them.

About 1.5 million low-income Americans have signed up for a card, Medicare chief Mark McClellan said. The administration had forecast that more than three times that many would enroll in the program by year’s end. More than 7 million people are eligible.

Highlighting the difficulty, the private companies that sponsor the drug cards sent nearly 2 million cards to low-income people in October and asked recipients to call a certain phone number to activate their cards. Only 100,000 have done so, Dr. McClellan said.

“The evidence is becoming overwhelming that the program does not work,” said Robert Hayes, president of the Medicare Rights Center, which is part of a coalition of civic groups trying to get cards to people who qualify for the assistance.

The low takeup rate is endemic to government aid programs, in which just one in five personstypically enroll after simply being told they are eligible, said James Firman, president of the National Council on the Aging and the leader of the Access to Benefits Coalition.

“People are skeptical. The benefits are complex and people often have low literacy. The process of deciding what to do and filling out the paperwork is hard work,” he said.

Mr. Hayes and other advocates say the administration is ignoring this history and taking the wrong approach by insisting that enrollment be voluntary. Instead, they say, the government should enroll everyone eligible, and those who object should be allowed to opt out of the program.

Dr. McClellan and other officials have been unstinting in their defense of the law, pointing out that older Americans without drug insurance will be getting help for the first time.

Nearly 6 million people have signed up for discount cards, designed as a bridge to the Medicare prescription-drug benefit that begins in 2006. The cards offer price breaks of 10 percent to 25 percent, on average, for those who do not receive the subsidy.

Dr. McClellan acknowledged the difficulty of reaching the poor in virtually all government programs.

“The unfortunate truth is … it can be really hard to find and then get enrolled and get helped the people the programs are intended to help,” he told a gathering of people who are trying to boost low-income enrollment.

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