90% of People Over Age 65 Have Prescription Drug Coverage, Many Enrolled in Medicare Benefit Concerned About Future Coverage, Study Says

More than 90% of U.S. residents ages 65 and older have some form of prescription drug coverage, in part because of enrollment in the Medicare prescription drug benefit, according to a study published Tuesday on the Health Affairs Web site, the Miami Herald reports (Hatcher, Miami Herald, 8/1). For the study, Daniel McFadden, a professor of economics at the University of California-Berkeley, and colleagues surveyed 1,571 seniors. About two million seniors who took at least one medication monthly and would benefit from the Medicare prescription drug benefit had not enrolled, according to the study (Lee, Washington Post, 8/1). The study finds that enrollment rates in the Medicare prescription drug benefit were lowest among healthy seniors, low-income seniors, widows, unmarried female seniors and seniors with low education levels (Miami Herald, 8/1). According to the study, about 40% of low-income seniors without a college education did not have prescription drug coverage. Only 11.3% of seniors with annual incomes of more than $20,000 did not have prescription drug coverage, the study finds. In addition, the study finds that seniors who took fewer medications were less likely to have prescription drug coverage than those who took more treatments. Only 5.2% of seniors who took three or more medications did not have prescription drug coverage, the study finds. The study attributes the results to "constraints or perceptions that make it difficult" for low-income seniors and those with low education levels to "account for future benefits." The study recommends the elimination the financial penalty for late enrollment in the Medicare prescription drug benefit to attract more seniors to the program and counseling targeted at healthy low-income seniors to inform them of the potential benefits of prescription drug coverage (Freking, Long Island Newsday, 8/1).

Opinions of Rx Drug Benefit
The study also examines opinions of seniors about the Medicare prescription drug benefit. According to the study, 58% of seniors considered the Medicare prescription drug benefit a "major benefit," and 30% praised the design of the program. However, 77% of seniors said that the Medicare prescription drug benefit should automatically enroll beneficiaries, and 88% consider the "doughnut hole" coverage gap a "significant drawback" of the program, the study finds. The Post also examined the findings of a survey of seniors released last week by the Kaiser Family Foundation (Washington Post, 8/1). The tracking survey found that more than eight in 10 seniors who are enrolled in Medicare drug plans are satisfied with their plans, while nearly two in 10 who have used their plans report experiencing a major problem with them (Kaiser Daily Health Policy Report, 7/28).

Comments
McFadden said, "The Part D program has performed better than some people feared, but it has also left a significant chunk of people uncovered. Many are people that any system would have difficulty reaching and helping make informed choices" (AP/Long Island Newsday, 8/1). He added, "People by and large seem to have been able to handle it and understand it." Drew Altman, president and CEO of the Kaiser Family Foundation said, "Overall so far there have definitely been bumps in the road in the implementation of the law, but it hasn't been the catastrophe that critics had predicted," adding, "There definitely are problems that require real attention." Leslie Norwalk, CMS deputy administrator, said, "We want to be sure that beneficiaries have prescription drug coverage," adding, "It's fine no matter where they get it, as long as they have it" (Washington Post, 8/1). Norwalk said, "Over time, people have grown to love their Medicare program, and I suspect people will grow to love their drug benefit. It just may take a while for the political waters to calm." Judith Stein, executive director of the Center for Medicare Advocacy, said, "Part D should be revisited and redesigned to offer a standardized prescription drug program through the traditional Medicare program. Such a program would be more valuable to more people with Medicare and less expensive for taxpayers" (AP/Long Island Newsday, 8/1).

An abstract of the study is available online.